Organization Active NPI

Richard H Lee Jr MD Inc

  • Ophthalmology Physician
  • Oakland, CA
National Provider Identifier
1063713311
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A24722 Issued in CA
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

Updated by the provider on Nov 3, 2010

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)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
1023129095MedicaidCA

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.