Individual provider Active NPI

Eugene Way Lee, MD

  • Plastic and Reconstructive Surgery Physician
  • Sacramento, CA
National Provider Identifier
1235247107
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
G041946 Issued in CA
Practice address
5120 J Street
Suite B
Sacramento, CA 95819-3840
Phone
(916) 454-9111
Fax
(916) 454-2977
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X G041946 CA Primary

Addresses

Primary practice location

5120 J Street
Suite B
Sacramento, CA 95819-3840

Mailing address

5120 J Street
Suite B
Sacramento, CA 95819-3840
Phone (916) 454-9111

Other identifiers 1

IdentifierTypeStateIssuer
8730518MedicaidCA

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
G041946CAMDPlastic and Reconstructive Surgery Physician
41946CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235247107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 J STREET",
            "address_2": "SUITE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193840",
            "telephone_number": "916-454-9111",
            "fax_number": "916-454-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 J STREET",
            "address_2": "SUITE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193840",
            "telephone_number": "916-454-9111",
            "fax_number": "916-454-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUGENE",
        "middle_name": "WAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G041946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8730518",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.