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General NPI Number Information
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NPI Number | 1659687226
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Entity Type | Organization
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Legal Business Name | YELLOW CROSS MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 903 CRENSHAW BLVD STE 302
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City | LOS ANGELES
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State | CA
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Zip | 90019-1967
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Country | US
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Telephone | 323-731-0681
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Fax | 323-731-0832
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Provider Business Mailing Address
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Address Line | 3544 W. OLYMPIC BLVD. STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90019-3500
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Country | US
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Telephone | 323-731-0681
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Fax | 323-731-0832
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Authorized Official
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Title or Position | PRESIDENT
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Name | YONG TAI LEE
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Credential | M.D.
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Telephone | 323-731-0681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G67974
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License Number State | CA
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