Active NPI
Sherlynn Ji Hyun Lee, PA-C
- Physician Assistant
- Buena Park, CA
National Provider Identifier
1366010597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 60301
- Practice address
- 5832 Beach Blvd Unit 209
Buena Park, CA 90621-5501 - Phone
- (714) 676-5541
- NPI assigned
- Jun 14, 2021
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 60301 | CA | Primary |
Addresses
Primary practice location
5832 Beach Blvd Unit 209
Buena Park, CA 90621-5501
Mailing address
5832 Beach Blvd Unit 209
Buena Park, CA 90621-5501
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240808002864 | CA | Order and Referring Only - Geriatric Medicine | 3072050996 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60301 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1366010597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5832 BEACH BLVD UNIT 209",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906215501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5832 BEACH BLVD UNIT 209",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906215501",
"telephone_number": "714-676-5541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SHERLYNN",
"middle_name": "JI HYUN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-14",
"last_updated": "2021-12-14",
"certification_date": "2021-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "60301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buena Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.