Provider Demographics
NPI:1821480377
Name:KORUS MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:KORUS MEDICAL CENTER, INC.
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOON
Authorized Official - Middle Name:HO
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-670-0007
Mailing Address - Street 1:26 CENTERPOINTE DR.
Mailing Address - Street 2:115
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-2567
Mailing Address - Country:US
Mailing Address - Phone:714-670-0007
Mailing Address - Fax:714-670-0005
Practice Address - Street 1:26 CENTERPOINTE DR.
Practice Address - Street 2:115
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-2567
Practice Address - Country:US
Practice Address - Phone:714-670-0007
Practice Address - Fax:714-670-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X, 208600000X, 208D00000X, 225100000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty