Provider Demographics
NPI:1457636037
Name:LLL-USA INTEGRATED HEALTH CARE ASSOCIATION
Entity Type:Organization
Organization Name:LLL-USA INTEGRATED HEALTH CARE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:XIAOBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-813-9430
Mailing Address - Street 1:2010 W CHESTER PIKE
Mailing Address - Street 2:SUITE 407
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2700
Mailing Address - Country:US
Mailing Address - Phone:610-853-2502
Mailing Address - Fax:610-853-2507
Practice Address - Street 1:2010 W CHESTER PIKE
Practice Address - Street 2:SUITE 407
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2700
Practice Address - Country:US
Practice Address - Phone:610-853-2502
Practice Address - Fax:610-853-2507
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVEREST MEDICAL CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058825L261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch