Provider Demographics
NPI:1801157896
Name:KARIN C. LI MD A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:KARIN C. LI MD A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:CHEN
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-325-2215
Mailing Address - Street 1:PO BOX 2240
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91788-2240
Mailing Address - Country:US
Mailing Address - Phone:951-220-9796
Mailing Address - Fax:951-254-9933
Practice Address - Street 1:13768 ROSWELL AVE STE 215
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-1407
Practice Address - Country:US
Practice Address - Phone:909-325-2215
Practice Address - Fax:888-491-0615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty