Organization Active NPI

Lee Renal Care

  • Nephrology Physician
  • Tarzana, CA
National Provider Identifier
1255949202
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
LEE RENAL CARE
Practice address
18370 Burbank Blvd Ste 211
Tarzana, CA 91356-2854
Phone
(747) 201-7444
NPI assigned
Jul 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Authorized official

Name
Dr. Sora Lee, MDNPI 1891939237
Title
Ceo
Phone
(747) 201-7444

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
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

18370 Burbank Blvd Ste 211
Tarzana, CA 91356-2854

Mailing address

18370 Burbank Blvd Ste 211
Tarzana, CA 91356-2854
Phone (747) 201-7444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200928000179 CA Part B Supplier - Clinic/Group Practice 6901225838 Receives reassigned benefits from 1 practitioner
Practice locations: Tarzana, 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": "1594857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1255949202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18370 BURBANK BLVD STE 211",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562854",
            "telephone_number": "747-201-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18370 BURBANK BLVD STE 211",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562854",
            "telephone_number": "747-201-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE RENAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SORA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-201-7444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.