Individual provider Active NPI

Daniel Woogun Lee, PA-C

  • Physician Assistant
  • Valencia, CA
National Provider Identifier
1457126336
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63498 Issued in CA
Practice address
24051 Newhall Ranch Rd BLDG C
Valencia, CA 91355-5702
Phone
(661) 254-6364
NPI assigned
Nov 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA63498 CA
Physician Assistant 363A00000X PA63498 CA Primary

Addresses

Primary practice location

24051 Newhall Ranch Rd BLDG C
Valencia, CA 91355-5702

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

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
I20240117002367 CA Practitioner - Physician Assistant 1355793142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 UCLA Medical PLZ
Suite 460
Los Angeles, CA 90024-7000
Phone (310) 443-8999

24051 Newhall Ranch Rd
BLDG C
Valencia, CA 91355-5702
Phone (661) 254-6364

2625 W Alameda Ave
Suite 116
Burbank, CA 91505-4815
Phone (818) 901-6600

757 Westwood PLZ
Los Angeles, CA 90095-0001
Phone (310) 825-9111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA63498CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Physician Assistant CurrentSince Mar 1, 2024 Accepting new patients
Regents of the University of California CurrentSince Mar 1, 2024 Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

5201 Truxtun Ave
Bakersfield, CA 93309
Phone (661) 328-5565

100 Medical Plz
Ste 460
Los Angeles, CA 90095
Phone (310) 825-6481

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

100 UCLA Medical Plz
Ste 460
Los Angeles, CA 90024
Phone (310) 443-8999

2655 1st St
Ste 300
Simi Valley, CA 93065
Phone (805) 578-8550

24051 Newhall Ranch Rd
Valencia, CA 91355
Phone (661) 254-6364

24051 Newhall Ranch Rd
Bldg C
Valencia, CA 91355
Phone (661) 254-6364

6815 Noble Ave
Van Nuys, CA 91405
Phone (818) 901-6690

Interoperability endpoints

  • Direct secure messaging: dlee1237305@direct.uclahealth.org

Organizations & group practices 4

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": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1457126336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24051 NEWHALL RANCH RD BLDG C",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555702",
            "telephone_number": "661-254-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DANIEL",
        "middle_name": "WOOGUN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-20",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA63498",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.