NPIMap

Organization Active NPI

Y J Lee MD Corp

Doing business as Pacific Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1336581123
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
Y J LEE MD CORP
Doing business as
Pacific Medical Group
Practice address
266 S Harvard Blvd Ste 100
Los Angeles, CA 90004-4374
Phone
(213) 383-9388
Fax
(213) 381-8660
NPI assigned
Jul 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Authorized official

Name
Young Jik Lee, M.D.
Title
M.D.
Phone
(213) 383-9388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

266 S Harvard Blvd Ste 100
Los Angeles, CA 90004-4374

Mailing address

266 S Harvard Blvd Ste 100
Los Angeles, CA 90004-4374
Phone (213) 383-9388

Other practice location 1

266 S Harvard Blvd Ste 300
Los Angeles, CA 90004-4373
Phone (213) 739-8610

Other names 1

  • PACIFIC MEDICAL GROUP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140224000343 CA Part B Supplier - Clinic/Group Practice 5193955920 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
Practice locations: Los Angeles, CA; Van Nuys, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1016965Y J Lee MD Corp266 S Harvard Blvd #100, Los Angeles, CA 90004Certificate of waiverSep 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pacific Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1374537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587081600000",
    "number": "1336581123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 S HARVARD BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044374",
            "telephone_number": "213-383-9388",
            "fax_number": "213-381-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 S HARVARD BLVD STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044374",
            "telephone_number": "213-383-9388",
            "fax_number": "213-381-8660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "266 S Harvard Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900044373",
            "country_code": "US",
            "telephone_number": "213-739-8610",
            "fax_number": "213-739-5771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "Y J LEE MD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-23",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_middle_name": "JIK",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "213-383-9388",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PACIFIC MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.

Verify at the official NPI Registry.