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General NPI Number Information
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NPI Number | 1366701633
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Entity Type | Organization
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Legal Business Name | NEUROPSYCHIATRIC MEDICAL GROUP
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 723 SOUTH GARFIELD AVE. STE. 303
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City | ALHAMBRA
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State | CA
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Zip | 91801-4430
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Country | US
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Telephone | 626-570-0041
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Fax | 626-570-0061
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Provider Business Mailing Address
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Address Line | 723 S GARFIELD AVE STE 303
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City | ALHAMBRA
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State | CA
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Zip | 91801-4430
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Country | US
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Telephone | 626-570-0041
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Fax | 626-570-0061
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WING-KI LEE
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Credential | M.D.
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Telephone | 626-570-0041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G51448
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License Number State | CA
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