Individual provider Active NPI

Timothy Tien-Min Lee, MD

  • Psychiatry Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1326254137
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A101050 Issued in CA
Practice address
10737 Laurel St Ste 230
Rancho Cucamonga, CA 91730-7659
Phone
(909) 989-5556
Fax
(909) 989-5558
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A101050 CA Primary

Addresses

Primary practice location

10737 Laurel St Ste 230
Rancho Cucamonga, CA 91730-7659

Mailing address

10737 Laurel St Ste 230
Rancho Cucamonga, CA 91730-7659
Phone (909) 989-5556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006001091 CA Practitioner - Psychiatry 8921290156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A101050CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System CurrentSince Aug 17, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 1, 2010 Accepting new patients
Sac Health System CurrentSince Aug 17, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 1, 2010 Accepting new patients
Sac Health System Current Accepting new patients

Locations

11234 Anderson St
Ofc Cp
Loma Linda, CA 92350
Phone 9095584000 ext. 88131

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1326254137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10737 LAUREL ST STE 230",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307659",
            "telephone_number": "909-989-5556",
            "fax_number": "909-989-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10737 LAUREL ST STE 230",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307659",
            "telephone_number": "909-989-5556",
            "fax_number": "909-989-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "TIMOTHY",
        "middle_name": "TIEN-MIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A101050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.