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General NPI Number Information
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NPI Number | 1124104427
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Entity Type | Organization
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Legal Business Name | WESTWOOD MEDICAL GROUP,INC.
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Dates
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Enumeration Date | 10/29/2006
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 505 S VIRGIL AVE SUITE 208
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City | LOS ANGELES
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State | CA
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Zip | 90020-1415
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Country | US
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Telephone | 213-739-0007
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Fax | 213-739-0011
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Provider Business Mailing Address
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Address Line | 505 S VIRGIL AVE SUITE 208
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City | LOS ANGELES
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State | CA
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Zip | 90020-1415
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Country | US
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Telephone | 213-739-0007
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Fax | 213-739-0011
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SONWOO LEE
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Credential | MD
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Telephone | 213-739-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A78554
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | A78556
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License Number State | CA
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