Jason Gong-Fung Lee, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA59315 Issued in CA

Practice address

9695 Base Line Rd
Rancho Cucamonga, CA 91730-1314

Phone

(909) 940-0920

NPI assigned

Jan 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Dalia Dawoud MD IncGroup PAC ID 7012370265, 19 clinicians

Carbon Health Medical Group of California PCGroup PAC ID 9032340047, 335 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dalia Dawoud MD Inc

  • Urgent Care Clinic/Center
  • Chino Hills, CA
  • NPI 1437867900
  Medicare reassignment Care Compare group NPD
• Carbon Health Medical Group of California PC

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  Medicare reassignment Care Compare group
• Exer Medical Corporation

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group
• SNF Wound Care

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1114393311
  Medicare reassignment
• Thuy T M Nguyen M D Inc

  • Urgent Care Clinic/Center
  • Montclair, CA
  • NPI 1558503169
  Medicare reassignment
• Carbon Health Medical Group of California PC

  • Urgent Care Clinic/Center
  • Pasadena, CA
  • NPI 1255957205
  NPD
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD (past)
• Dalia Dawoud MD Inc

  • Urgent Care Clinic/Center
  • Rancho Santa Margarita, CA
  • NPI 1639990492
  NPD (past)
• Smartclinic Inc

  • Urgent Care Clinic/Center
  • West Covina, CA
  • NPI 1881828317
  NPD (past)

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1194316604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9695 BASE LINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301314",
            "telephone_number": "626-941-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9695 BASE LINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301314",
            "telephone_number": "909-940-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "middle_name": "GONG-FUNG",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA59315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassondra Ledezma
• Lee Austin and Ishrat Husain MDS
• Albert Lee, DDS
• Calvin Lee, MA, OTR/L
• Jared Wing Lee, PHARMD
• Jennifer Lee
• Jenny Hyun Jin Lee, PHARM.D.
• Jonathan Gene Lee, FNP-BC
• Joseph Lee, DDS
• Jung Yeol Lee, DMD

• Medical Physician Assistant in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.