=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801157896
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KARIN C LI MD A PROF MED CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2012
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13768 ROSWELL AVE STE 215
-----------------------------------------------------
City | CHINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91710-1407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-325-2215
-----------------------------------------------------
Fax | 888-491-0615
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2240
-----------------------------------------------------
City | WALNUT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91788-2240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-220-9796
-----------------------------------------------------
Fax | 951-254-9933
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. KARIN CHEN LI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 909-325-2215
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------