Individual provider Active NPI

Gin-Horn Daniel Lee, D.P.M.

  • Podiatrist
  • Monterey Park, CA
National Provider Identifier
1104806199
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3887 Issued in CA
Practice address
420 N Garfield Ave
Suite#206
Monterey Park, CA 91754-1206
Phone
(626) 572-8950
Fax
(626) 572-9487
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3887 CA Primary

Addresses

Primary practice location

420 N Garfield Ave
Suite#206
Monterey Park, CA 91754-1206

Mailing address

420 N Garfield Ave
Suite#206
Monterey Park, CA 91754-1206
Phone (626) 572-8950

Other identifiers 1

IdentifierTypeStateIssuer
2905638MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3887CAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1104806199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N GARFIELD AVE",
            "address_2": "SUITE#206",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541206",
            "telephone_number": "626-572-8950",
            "fax_number": "626-572-9487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N GARFIELD AVE",
            "address_2": "SUITE#206",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541206",
            "telephone_number": "626-572-8950",
            "fax_number": "626-572-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GIN-HORN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2905638",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.