Active NPI
Bongsoo Edwin Lee, D.C.
- Sports Physician Chiropractor
- Torrance, CA
National Provider Identifier
1285721589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 20285
- Practice address
- 4305 Torrance Blvd
Suite 400
Torrance, CA 90503-4409 - Phone
- (310) 530-3032
- NPI assigned
- Oct 6, 2006
- 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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 20285 | CA | Primary |
Addresses
Primary practice location
4305 Torrance Blvd
Suite 400
Torrance, CA 90503-4409
Mailing address
4305 Torrance Blvd.
Suite 400
Torrance, CA 90503-4404
Phone (310) 530-3032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081224000005 | CA | Practitioner - Chiropractic | 8224190376 | Practice locations: Torrance, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4305 Torrance Blvd
Suite 400
Torrance, CA 90503-4404
Phone (310) 530-3032
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230681600000",
"number": "1285721589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4305 TORRANCE BLVD.",
"address_2": "SUITE 400",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905034404",
"telephone_number": "310-530-3032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4305 TORRANCE BLVD",
"address_2": "SUITE 400",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905034409",
"telephone_number": "310-530-3032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "BONGSOO",
"middle_name": "EDWIN",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2008-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "CA",
"license": "20285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; 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.