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General NPI Number Information
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NPI Number | 1306006655
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Entity Type | Organization
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Legal Business Name | A-ONE MEDICAL GROUP, INC. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 08/03/2017
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Provider Practice Location Address
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Address Line | 2705 S DIAMOND BAR BLVD UNIT #100
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City | DIAMOND BAR
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State | CA
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Zip | 91765-3512
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Country | US
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Telephone | 626-965-1988
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Fax | 626-236-9394
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Provider Business Mailing Address
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Address Line | 2705 S DIAMOND BAR BLVD UNIT #100
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City | DIAMOND BAR
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State | CA
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Zip | 91765-3512
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Country | US
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Telephone | 626-965-1988
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Fax | 626-236-9394
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID P. LEE
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Credential | D.O.
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Telephone | 626-965-1988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A7715
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License Number State | CA
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