Organization Active NPI

Paul Choong Hwan Lee MD a Medical Corporation

  • Ophthalmology Physician
  • Fullerton, CA
National Provider Identifier
1407096332
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A75260 Issued in CA
Legal business name
PAUL CHOONG HWAN LEE MD A MEDICAL CORPORATION
Practice address
1401 S Brookhurst Rd
Suite 105
Fullerton, CA 92833-4471
Phone
(714) 539-3232
Fax
(714) 539-3555
NPI assigned
Mar 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Dr. Paul Choong Hwan Lee, MD
Title
President
Phone
(714) 539-3232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A75260 CA Primary

Addresses

Primary practice location

1401 S Brookhurst Rd
Suite 105
Fullerton, CA 92833-4471

Mailing address

9894 Garden Grove Blvd
Garden Grove, CA 92844-1643
Phone (714) 539-3232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090721000382 CA Part B Supplier - Clinic/Group Practice 0244382315 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fullerton, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1407096332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9894 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441643",
            "telephone_number": "714-539-3232",
            "fax_number": "714-539-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BROOKHURST RD",
            "address_2": "SUITE 105",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334471",
            "telephone_number": "714-539-3232",
            "fax_number": "714-539-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL CHOONG HWAN LEE MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-05",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "CHOONG HWAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-539-3232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A75260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.