Individual provider Active NPI

Wonhee Lee

  • Family Nurse Practitioner
  • Garden Grove, CA
National Provider Identifier
1407338585
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009420 Issued in CA
Practice address
12665 Garden Grove Blvd Ste 503
Garden Grove, CA 92843-1919
Phone
(714) 530-3740
Fax
(714) 530-0582
NPI assigned
Sep 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009420 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd Ste 503
Garden Grove, CA 92843-1919

Mailing address

12665 Garden Grove Blvd Ste 503
Garden Grove, CA 92843-1919
Phone (714) 530-3740

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200217000417 CA Practitioner - Nurse Practitioner 0547697336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95009420CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hong S. Kim, M.D., Inc CurrentSince Oct 5, 2019 Accepting new patients

Locations

12665 Garden Grove Blvd
Ste 503
Garden Grove, CA 92843
Phone (714) 530-3740

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1407338585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 503",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431919",
            "telephone_number": "714-530-3740",
            "fax_number": "714-530-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 503",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431919",
            "telephone_number": "714-530-3740",
            "fax_number": "714-530-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "WONHEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.