Organization Active NPI

Edmond Lee DPM, Inc.

  • Podiatrist
  • Monterey Park, CA
National Provider Identifier
1194025957
Registry record updated Jan 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
EDMOND LEE DPM, INC.
Practice address
500 N Garfield Ave Ste 305
Monterey Park, CA 91754-1242
Phone
(626) 703-4188
Fax
(213) 617-3144
NPI assigned
Oct 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2021

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

Authorized official

Name
Kadie Lee
Title
Authorized Official
Phone
(909) 979-4493

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X CA Primary
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

500 N Garfield Ave Ste 305
Monterey Park, CA 91754-1242

Mailing address

500 N Garfield Ave Ste 305
Monterey Park, CA 91754-1242
Phone (626) 703-4188

Other practice location 1

531 W College St Fl 2
Los Angeles, CA 90012-2315
Phone (213) 620-8702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101130000724 CA DME Supplier - Physician - Podiatry 2769678937 Practice locations: Monterey Park, CA
O20110104000029 CA Part B Supplier - Clinic/Group Practice 2769678937 Receives reassigned benefits from 1 practitioner
Practice locations: Monterey Park, CA

National Provider Directory

National Provider Directory

Locations

531 W College St
Fl 2
Los Angeles, CA 90012
Phone (213) 620-8702

711 W College St
Ste 520
Los Angeles, CA 90012
Phone (213) 620-8702

Practitioners & affiliated clinicians

Practitioners 2

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": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610841600000",
    "number": "1194025957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE STE 305",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-703-4188",
            "fax_number": "213-617-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE STE 305",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-703-4188",
            "fax_number": "213-617-3144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 W College St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900122315",
            "country_code": "US",
            "telephone_number": "213-620-8702",
            "fax_number": "213-617-3144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDMOND LEE DPM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2021-01-17",
        "certification_date": "2021-01-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KADIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "909-979-4493"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jan 17, 2021; 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.