NPIMap

Organization Active NPI

Ji Yon Lee MD, Inc

Doing business as Grace Pediatrics

  • Pediatrics Physician
  • Irvine, CA
National Provider Identifier
1043617939
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A108338 Issued in CA
Legal business name
JI YON LEE MD, INC
Doing business as
Grace Pediatrics
Practice address
4902 Irvine Center Dr Ste 102
Irvine, CA 92604-3334
Phone
(949) 757-3690
Fax
(949) 596-9146
NPI assigned
Nov 21, 2014
Last updated
Apr 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Ji Yon Han, MDNPI 1285858274
Title
Ceo
Phone
(949) 757-3690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A108338 CA Primary

Addresses

Primary practice location

4902 Irvine Center Dr Ste 102
Irvine, CA 92604-3334

Mailing address

4902 Irvine Center Dr Ste 102
Irvine, CA 92604-3334
Phone (949) 757-3690

Other practice location 1

125 N Euclid St
Fullerton, CA 92832-1618
Phone (714) 773-1212

Other names 1

  • GRACE PEDIATRICS Doing business as

National Provider Directory

National Provider Directory

Locations

17305 Von Karman Ave
Ste 111
Irvine, CA 92614
Phone (714) 615-5133

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1043617939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR STE 102",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043334",
            "telephone_number": "949-757-3690",
            "fax_number": "949-596-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR STE 102",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043334",
            "telephone_number": "949-757-3690",
            "fax_number": "949-596-9146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 N Euclid St",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928321618",
            "country_code": "US",
            "telephone_number": "714-773-1212",
            "fax_number": "714-773-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JI YON LEE MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-21",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "JI",
        "authorized_official_middle_name": "YON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-757-3690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A108338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRACE PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRACE PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

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