MEDICARE: DR. LEI JIANG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	A127462	DC

General Provider Information

NPI Number	:	1689800468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEI JIANG M.D.

Provider Business Mailing Address
First Line	:	100 E CALIFORNIA BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3205
Country	:	US
Telephone Number	:	626-269-5371
Fax Number	:

Provider Business Practice Location Address
First Line	:	17833 COLIMA RD
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91748-1729
Country	:	US
Telephone Number	:	626-964-7764
Fax Number	:	626-913-2910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2009
Last Update Date	:	11/29/2021

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