Organization Active NPI

Jai H Lee MD a Professional Corporation

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1205247376
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A38492 Issued in CA
Legal business name
JAI H LEE MD A PROFESSIONAL CORPORATION
Practice address
520 S Virgil Ave
Suite 103
Los Angeles, CA 90020-1416
Phone
(213) 380-0028
Fax
(213) 380-0036
NPI assigned
May 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Jai H Lee, M.D.NPI 1720007420
Title
President
Phone
(213) 380-0028

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
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X A38492 CA Primary

Addresses

Primary practice location

520 S Virgil Ave
Suite 103
Los Angeles, CA 90020-1416

Mailing address

520 S Virgil Ave
Suite 103
Los Angeles, CA 90020-1416
Phone (213) 380-0028

Other identifiers 1

IdentifierTypeStateIssuer
A38492OtherCAPROFESSIONAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140729001879 CA Part B Supplier - Clinic/Group Practice 4284850124 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1205247376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S VIRGIL AVE",
            "address_2": "SUITE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201416",
            "telephone_number": "213-380-0028",
            "fax_number": "213-380-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S VIRGIL AVE",
            "address_2": "SUITE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201416",
            "telephone_number": "213-380-0028",
            "fax_number": "213-380-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAI H LEE MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-380-0028",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A38492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "A38492",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.