Lee Rice D.O. Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A3360 Issued in CA

Legal business name

LEE RICE D.O. MEDICAL CORPORATION

Practice address

2448 Historic Decatur Rd Ste 130
San Diego, CA 92106-6127

Phone

(619) 398-2960

Fax

(619) 398-2970

NPI assigned

Apr 2, 2018

Organization subpart

No

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

Authorized official

Name

David M Larson, MD

Title

Physician

Phone

(619) 398-2960

Specialties & licenses 4

Addresses

Other names 1

• Lifewellness Institute Doing business as

Locations

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1376049049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 HISTORIC DECATUR RD STE 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066127",
            "telephone_number": "619-398-2960",
            "fax_number": "619-398-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 HISTORIC DECATUR RD STE 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066127",
            "telephone_number": "619-398-2960",
            "fax_number": "619-398-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE RICE D.O. MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "619-398-2960",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A3360",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A122666",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A3360",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A122666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifewellness Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ellie M Ledgerwood
• Maria Teresa Ledyard, NP
• Amanda Soonja Lee Cruz, MD
• Alicia Lee Fong, LMFT
• Moon Reng Lee Kim, L.AC.
• Akira Lee-Ade
• Vivien Lee-David
• Joo Yun Lee-Hong
• Clara Joyce Lee-Zimmerman, MD
• Aaron Lee

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.