Organization Active NPI

Michael Women's Medical Clinic

  • Obstetrics & Gynecology Physician
  • Pomona, CA
National Provider Identifier
1386654143
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MICHAEL WOMEN'S MEDICAL CLINIC
Practice address
920 N Garey Ave
Pomona, CA 91767-4618
Phone
(909) 623-3591
Fax
(909) 623-3504
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Dr. Robert S Lee, D.O.
Title
Owner/Medical Director
Phone
(909) 623-3591

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

920 N Garey Ave
Pomona, CA 91767-4618

Mailing address

920 N Garey Ave
Pomona, CA 91767-4618
Phone (909) 623-3591

Other identifiers 1

IdentifierTypeStateIssuer
GR0076350MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1386654143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917674618",
            "telephone_number": "909-623-3591",
            "fax_number": "909-623-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917674618",
            "telephone_number": "909-623-3591",
            "fax_number": "909-623-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WOMEN'S MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-623-3591",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0076350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.