Minimally Invasive Therapies a Professional Corporation

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A49819 Issued in CA

Legal business name

MINIMALLY INVASIVE THERAPIES A PROFESSIONAL CORPORATION

Practice address

18400 US Highway 18
Suite a
Apple Valley, CA 92307-2306

Phone

(760) 242-3939

Fax

(760) 810-7593

NPI assigned

Aug 25, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Shin Kwon Lee, M.D.

Title

Ceo

Phone

(660) 349-0020

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1700332285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11202 LINDSAY LN",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923083637",
            "telephone_number": "660-349-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18400 US HIGHWAY 18",
            "address_2": "SUITE A",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072306",
            "telephone_number": "760-242-3939",
            "fax_number": "760-810-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE THERAPIES A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "SHIN KWON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "660-349-0020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A49819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seana Koreen Miller
• Timothy James Miller
• Kimberly Millet
• Mindfully Balanced
• Mindfully Balanced Mental Health and Wellness Foundation
• Kenneth Miranda, PPS
• Hansal Mistry, MD
• Angela Mitchell, APCC
• James William Mitchell, MA, LMFC
• Luis Andres Mitchell

• Urology Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.