Healthcare Provider Details

I. General information

NPI: 1033429691
Provider Name (Legal Business Name): LEMUS MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 E. WASHINGTON BLVD.
COMMERCE CA
90040-1237
US

IV. Provider business mailing address

5020 E. WASHINGTON BLVD.
COMMERCE CA
90040-1237
US

V. Phone/Fax

Practice location:
  • Phone: 323-260-7900
  • Fax: 323-260-1087
Mailing address:
  • Phone: 323-260-7900
  • Fax: 323-260-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberG42274
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES LEMUS
Title or Position: PRESIDENT/PHYSICIAN
Credential: M.D.
Phone: 323-260-7900