Glendale Community Family Practice Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A85330 Issued in CA

Legal business name

GLENDALE COMMUNITY FAMILY PRACTICE INC.

Practice address

316 E Broadway # B
Glendale, CA 91205-1011

Phone

(818) 956-2001

NPI assigned

Mar 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Woo Sok Lee, M.D.NPI 1386663185

Title

Owner

Phone

(818) 956-2001

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Woo Sok Lee, M.D.

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1386663185
  Authorized official Same address or phone

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407988058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900270206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 E BROADWAY # B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051011",
            "telephone_number": "818-956-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE COMMUNITY FAMILY PRACTICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WOO",
        "authorized_official_middle_name": "SOK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-956-2001",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A85330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Glendale, CA
• Providers in Glendale, 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 Aug 22, 2020; 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.