NPIMap

Organization Active NPI

Functional Medicine and Psychiatry Inc.

  • Psychiatry Physician
  • La Canada Flintridge, CA
National Provider Identifier
1043953235
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FUNCTIONAL MEDICINE AND PSYCHIATRY INC.
Practice address
4358 Chevy Chase Dr
La Canada Flintridge, CA 91011-3203
Phone
(626) 449-7000
NPI assigned
Apr 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Authorized official

Name
Dr. John Lee, MDNPI 1689618464
Title
President
Phone
(626) 449-7000

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4358 Chevy Chase Dr
La Canada Flintridge, CA 91011-3203

Mailing address

115 W California Blvd Unit 9001
Pasadena, CA 91105-3005
Phone (626) 449-7000

Other identifiers 1

IdentifierTypeStateIssuer
1689618464OtherCANPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.drchrono.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1043953235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W CALIFORNIA BLVD UNIT 9001",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053005",
            "telephone_number": "626-449-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4358 CHEVY CHASE DR",
            "city": "LA CANADA FLINTRIDGE",
            "state": "CA",
            "postal_code": "910113203",
            "telephone_number": "626-449-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL MEDICINE AND PSYCHIATRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-449-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689618464",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.drchrono.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "EHR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "EHR",
            "address_1": "4358 Chevy Chase Dr",
            "city": "LA Canada Flintridge",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910113203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Canada Flintridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.