Individual provider Active NPI

Lee G. Dykstra, MD

  • Cardiovascular Disease Physician
  • Bellflower, CA
National Provider Identifier
1235206178
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G32009 Issued in CA
Practice address
9400 Rosecrans Ave
Bellflower, CA 90706-2246
Phone
(562) 461-3000
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G32009 CA Primary

Addresses

Primary practice location

9400 Rosecrans Ave
Bellflower, CA 90706-2246

Mailing address

9400 Rosecrans Ave
Bellflower, CA 90706-2246
Phone (562) 461-3000

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G32009CAMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1235206178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ROSECRANS AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907062246",
            "telephone_number": "562-461-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 ROSECRANS AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907062246",
            "telephone_number": "562-461-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "LEE",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G32009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellflower, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.