Active NPI
Hyun Dong Lee, DC
- Chiropractor
- Tustin, CA
National Provider Identifier
1255814711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 34301
- Practice address
- 14591 Newport Ave Ste 106
Tustin, CA 92780 - Phone
- (714) 714-0972
- Fax
- (714) 486-2520
- NPI assigned
- Sep 11, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 34301 | CA | Primary |
Addresses
Primary practice location
14591 Newport Ave Ste 106
Tustin, CA 92780
Mailing address
14591 Newport Ave Ste 106
Tustin, CA 92780-6026
Phone (714) 714-0972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190701002202 | CA | Practitioner - Chiropractic | 1355675984 | Practice locations: Tustin, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
14591 Newport Ave
Suite 106
Tustin, CA 92780-6026
Phone (714) 714-0972
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34301 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558137600000",
"number": "1255814711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14591 NEWPORT AVE STE 106",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927806026",
"telephone_number": "714-714-0972",
"fax_number": "714-486-2520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14591 NEWPORT AVE STE 106",
"city": "TUSTIN",
"state": "CA",
"postal_code": "92780",
"telephone_number": "714-714-0972",
"fax_number": "714-486-2520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "HYUN DONG",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-11",
"last_updated": "2019-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "34301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.