Connie J Li MD a Professional Corporation

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CONNIE J LI MD A PROFESSIONAL CORPORATION

Practice address

22542 Lark Spring Ter
Diamond Bar, CA 91765-2956

Phone

(909) 499-6588

NPI assigned

Mar 10, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Connie J Li, M.D.

Title

President / Ceo

Phone

(909) 499-6588

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1174064091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22542 LARK SPRING TER",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652956",
            "telephone_number": "909-499-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22542 LARK SPRING TER",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652956",
            "telephone_number": "909-499-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNIE J LI MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "909-499-6588",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.