NPIMap

Organization Active NPI

Yong Luke Lee Medical Corporation

  • Rehabilitation Hospital
  • Pomona, CA
National Provider Identifier
1114245883
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
A39217 Issued in CA
Legal business name
YONG LUKE LEE MEDICAL CORPORATION
Practice address
255 East Bonita
Pomona, CA 91769-6001
Phone
(909) 450-0115
Fax
(909) 593-0096
NPI assigned
May 5, 2010
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Mr. Yong Luke Lee, MDNPI 1760468508
Title
Owner
Phone
(909) 484-2865

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
Rehabilitation Hospital 283X00000X A39217 CA Primary

Addresses

Primary practice location

255 East Bonita
Pomona, CA 91769-6001

Mailing address

8816 Foothill Blvd Ste 103
Rancho Cucamonga, CA 91730-7199
Phone (909) 484-2865

Other identifiers 1

IdentifierTypeStateIssuer
1114245883MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100513000167 CA Part B Supplier - Clinic/Group Practice 0648308569 Receives reassigned benefits from 1 practitioner
Practice locations: Pomona, CA; Upland, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 121

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.

View all 121

NPI Registry JSON

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1114245883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8816 FOOTHILL BLVD STE 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307199",
            "telephone_number": "909-484-2865",
            "fax_number": "909-941-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EAST BONITA",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917696001",
            "telephone_number": "909-450-0115",
            "fax_number": "909-593-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YONG LUKE LEE MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "YONG",
        "authorized_official_middle_name": "LUKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-484-2865",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "CA",
            "license": "A39217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114245883",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.