Bennett Lee, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G64625 Issued in CA

Practice address

2755 Alamo St
Suite 101
Simi Valley, CA 93065-1311

Phone

(805) 522-6577

Fax

(805) 522-7030

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: bennett.lee.p1@direct.lakeside.nextgenshare.com

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1023051174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD",
            "address_2": "SUITE 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913253583",
            "telephone_number": "818-357-5048",
            "fax_number": "818-654-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 ALAMO ST",
            "address_2": "SUITE 101",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651311",
            "telephone_number": "805-522-6577",
            "fax_number": "805-522-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "BENNETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G64625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G646250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurence J.S. Weekes M.D. and Linda Tigner Weekes, M.D. Inc.
• John Charles Laux
• Phillip Lavine, DC
• Sukhmani K Layal, M.D.
• Dong Quoc Le, O.D.
• Ga Yi Lee, M.D.
• Jennifer Eun Joo Lee, D.O.
• Jennifer Nicole Lee, M.A., B.C.B.A.
• Kenon Lee
• Myungjae Lee, L.AC.

• Family Medicine Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.