Organization · NPI-2

Bryan X Lee MD A Professional Medical Corporation

Pain Medicine, Interventional Pain Medicine · Pomona, CA

NPI number1144526773
StatusActive
Last updated in NPPESFeb 16, 2023

Details

NPI
1144526773
Entity type
Organization (NPI-2)
Legal business name
Bryan X Lee MD A Professional Medical Corporation
Organization subpart
No
Enumeration date
Jan 30, 2011
Certification date
Feb 16, 2023
Last updated
Feb 16, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208VP0014X Pain Medicine, Interventional Pain MedicineA91137CAYes
207LP2900X Anesthesiology, Pain MedicineA91137CA
207R00000X Internal MedicineA96828CA

Other names

  • Southern California Center For Pain Management (Doing Business As)

Practice location

250 W Bonita Ave
Suite 160
Pomona, CA 91767-1863

Phone 909-593-1002 · Fax 888-257-3888

Mailing address

Po Box 2240
Walnut, CA 91788-2240

Phone 909-593-1002 · Fax 909-593-1004

Other practice locations

13768 Roswell Ave Ste 215
Chino, CA 91710-1407

Phone 909-593-1002 · Fax 888-257-3888

Authorized official

Bryan X Lee
President
9095931002

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