Candice Ji Eun Lee-Wang, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A144571 Issued in CA

Practice address

264 N Highland Springs Ave Ste 4
Banning, CA 92220-3082

Phone

(951) 769-0079

Fax

(888) 854-7592

NPI assigned

Jun 19, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Neighborhood Healthcare

  dba Neighborhood Healthcare - Beaumont

  • Federally Qualified Health Center (FQHC)
  • Beaumont, CA
  • NPI 1629601653
  NPD (past)

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396184685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 N. HIGHLAND SPRINGS",
            "address_2": "SUITE 4",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "92220",
            "telephone_number": "951-769-0079",
            "fax_number": "888-854-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 N HIGHLAND SPRINGS AVE STE 4",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203082",
            "telephone_number": "951-769-0079",
            "fax_number": "888-854-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-WANG",
        "first_name": "CANDICE",
        "middle_name": "JI EUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A144571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Laube
• Ronda Lawhon
• Denise Lawson
• Thomas M. Layte, LCSW
• Vinh John Xuan Le, MD
• Jow Shone Lee, M.D.
• Julia Lee, M.D.
• Michael Joe Lee, MD
• Kristen Lew, M.D
• Carlotta Lewis

• Family Medicine Physician in Banning, CA
• Providers in Banning, 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 Jul 21, 2022; 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.

Verify at the official NPI Registry.