=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326389586
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEVIN LEE METROS, M.D., A PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2013
-----------------------------------------------------
Last Update Date | 03/12/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 735 E OHIO AVE SUITE 203
-----------------------------------------------------
City | ESCONDIDO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92025-3437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-738-7224
-----------------------------------------------------
Fax | 760-738-6138
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 735 E OHIO AVE SUITE 203
-----------------------------------------------------
City | ESCONDIDO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92025-3437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-738-7224
-----------------------------------------------------
Fax | 760-738-6138
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KEVIN LEE METROS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 760-738-7224
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | G71444
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------