Individual provider Active NPI

Harrison Lee, D.O.

  • Family Medicine Physician
  • Carson, CA
National Provider Identifier
1033439765
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A12200 Issued in CA
Practice address
824 E Carson St Ste 104
Carson, CA 90745-2262
Phone
(310) 793-3520
NPI assigned
Jun 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A12200 CA Primary

Addresses

Primary practice location

824 E Carson St Ste 104
Carson, CA 90745-2262

Mailing address

824 E Carson St Ste 104
Carson, CA 90745-2262
Phone (310) 793-3520

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121022000733 CA Practitioner - Family Practice 2860642139 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

393 E Walnut St
Pasaden, CA 91188-0001
Phone (877) 608-0044

393 E Walnut St 3Rd FL
Pasadena, CA 91188-0001

5300 McConnell Ave
Los Angeles, CA 90066-7026
Phone (833) 574-2273

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - West la Hospital, Los Angeles, CA, CCN 050561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Aug 12, 2013 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Aug 12, 2013 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 20, 2015 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 20, 2015 Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1033439765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 E CARSON ST STE 104",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452262",
            "telephone_number": "310-793-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 E CARSON ST STE 104",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452262",
            "telephone_number": "310-793-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "HARRISON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.