| Reform24 Medical Group Inc | |
|
9535 Garden Grove Blvd 102 Garden Grove CA 92844-1550 | |
| (714) 534-1112 | |
| (714) 534-1116 |
| Full Name | Reform24 Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 9535 Garden Grove Blvd, Garden Grove, California |
| Authorized Official Name and Position | Yong Ho Lee (DIRECTOR) |
| Authorized Official Contact | 7145341112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reform24 Medical Group Inc 9535 Garden Grove Blvd 102 Garden Grove CA 92844-1550 Ph: (714) 534-1112 | Reform24 Medical Group Inc 9535 Garden Grove Blvd 102 Garden Grove CA 92844-1550 Ph: (714) 534-1112 |
| NPI Number | 1053718288 |
|---|---|
| Provider Enumeration Date | 12/03/2014 |
| Last Update Date | 12/03/2014 |
| Medicare PECOS PAC ID | 9335465301 |
|---|---|
| Medicare Enrollment ID | O20150310001825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053718288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Yong Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407007594 PECOS PAC ID: 3072778356 Enrollment ID: I20120712000273 |
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