Active NPI
Richard H Lee Jr MD Inc
- Ophthalmology Physician
- Oakland, CA
National Provider Identifier
1063713311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- A24722
- Legal business name
- RICHARD H LEE JR MD INC
- Practice address
- 491 30TH Street
#201
Oakland, CA 94609-3235 - Phone
- (510) 836-2122
- NPI assigned
- Nov 3, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Richard H Lee Jr., M.D.
- Title
- Medical Doctor
- Phone
- (510) 836-2122
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A24722 | CA | Primary |
Addresses
Primary practice location
491 30TH Street
#201
Oakland, CA 94609-3235
Mailing address
491 30TH Street
#201
Oakland, CA 94609-3235
Phone (510) 836-2122
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023129095 | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288742400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1288742400000",
"number": "1063713311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "491 30TH STREET",
"address_2": "#201",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093235",
"telephone_number": "510-836-2122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "491 30TH STREET",
"address_2": "#201",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093235",
"telephone_number": "510-836-2122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RICHARD H LEE JR MD INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-11-03",
"last_updated": "2010-11-03",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "MEDICAL DOCTOR",
"authorized_official_telephone_number": "510-836-2122",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "CA",
"license": "A24722",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023129095",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.