| Lysander Jim, M.d. Inc | |
|
452 N Altadena Dr Pasadena CA 91107-2536 | |
| (626) 800-3860 | |
| Not Available |
| Full Name | Lysander Jim, M.d. Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 452 N Altadena Dr, Pasadena, California |
| Authorized Official Name and Position | Lysander Jim (PRESIDENT) |
| Authorized Official Contact | 6268003860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lysander Jim, M.d. Inc 601 Camino Verde S Pasadena CA 91030-4139 Ph: (626) 800-3860 | Lysander Jim, M.d. Inc 452 N Altadena Dr Pasadena CA 91107-2536 Ph: (626) 800-3860 |
| NPI Number | 1639619414 |
|---|---|
| Provider Enumeration Date | 02/27/2017 |
| Last Update Date | 02/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639619414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3985886 (California) | Primary |
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