Active NPI
Susan Lee
- Emergency Registered Nurse
- Glendora, CA
National Provider Identifier
1285281774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Registered Nurse
- License
- 709355
- Practice address
- 250 S Grand Ave
Glendora, CA 91741-4218 - Phone
- (626) 857-3180
- NPI assigned
- Aug 20, 2019
- Last updated
- Aug 20, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 709355 | CA | Primary |
Addresses
Primary practice location
250 S Grand Ave
Glendora, CA 91741-4218
Mailing address
250 S Grand Ave
Glendora, CA 91741-4218
Phone (626) 857-3180
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 709355 | CA | MD | Emergency Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1285281774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 S GRAND AVE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917414218",
"telephone_number": "626-857-3180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 S GRAND AVE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917414218",
"telephone_number": "626-857-3180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-20",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "CA",
"license": "709355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.