NPIMap

Organization Active NPI

California Cardiothoracic Associates Medical GRP

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynwood, CA
National Provider Identifier
1396858122
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
CALIFORNIA CARDIOTHORACIC ASSOCIATES MEDICAL GRP
Practice address
3630 E Imperial Hwy
Suite 2101
Lynwood, CA 90262-2636
Phone
(310) 826-2073
Fax
(310) 826-9353
NPI assigned
Aug 16, 2006
Last updated
Oct 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Authorized official

Name
Dr. Anthony Wong Lee, MDNPI 1205857836
Title
General Partner
Phone
(310) 603-6562

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X CA Primary

Addresses

Primary practice location

3630 E Imperial Hwy
Suite 2101
Lynwood, CA 90262-2636

Mailing address

11500 San Vicente Blvd
Suite 409
Los Angeles, CA 90049-6218
Phone (310) 826-2073

Other identifiers 1

IdentifierTypeStateIssuer
GR0078730MedicaidCA

National Provider Directory

National Provider Directory

Locations

3630 E Imperial Hwy
Ste 21
Lynwood, CA 90262
Phone (310) 603-6562

3630 E Imperial Hwy
Ste 2101
Lynwood, CA 90262
Phone (310) 603-6562

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1396858122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 SAN VICENTE BLVD",
            "address_2": "SUITE 409",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496218",
            "telephone_number": "310-826-2073",
            "fax_number": "310-826-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "address_2": "SUITE 2101",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622636",
            "telephone_number": "310-826-2073",
            "fax_number": "310-826-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA CARDIOTHORACIC ASSOCIATES MEDICAL GRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "WONG",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "310-603-6562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.