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General NPI Number Information
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NPI Number | 1184780363
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Entity Type | Organization
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Legal Business Name | JL PLASTIC SURGERY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 11550 INDIAN HILLS RD STE 310
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City | MISSION HILLS
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State | CA
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Zip | 91345-1203
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Country | US
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Telephone | 818-626-8420
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Fax | 866-414-0020
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Provider Business Mailing Address
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Address Line | 11550 INDIAN HILLS RD STE 310
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City | MISSION HILLS
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State | CA
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Zip | 91345-1203
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Country | US
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Telephone | 818-626-8420
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Fax | 866-414-0020
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES J LEE
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Credential | MD
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Telephone | 818-626-8420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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