Yellow Cross Medical Clinic, Inc. | |
903 Crenshaw Blvd Ste 302 Los Angeles CA 90019-1967 | |
(323) 731-0681 | |
(323) 731-0832 |
Full Name | Yellow Cross Medical Clinic, Inc. |
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Speciality | Clinic/Center |
Location | 903 Crenshaw Blvd Ste 302, Los Angeles, California |
Authorized Official Name and Position | Yong Tai Lee (PRESIDENT) |
Authorized Official Contact | 3237310681 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Yellow Cross Medical Clinic, Inc. 3544 W. Olympic Blvd. Ste 100 Los Angeles CA 90019-3500 Ph: (323) 731-0681 | Yellow Cross Medical Clinic, Inc. 903 Crenshaw Blvd Ste 302 Los Angeles CA 90019-1967 Ph: (323) 731-0681 |
NPI Number | 1659687226 |
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Provider Enumeration Date | 08/20/2010 |
Last Update Date | 09/19/2019 |
Medicare PECOS PAC ID | 0941493753 |
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Medicare Enrollment ID | O20101025000399 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659687226 | NPI | - | NPPES |
1659687226 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | G67974 (California) | Primary |
Provider Name | Yong Tai Lee |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972607364 PECOS PAC ID: 4284535089 Enrollment ID: I20101025000539 |
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