Individual provider Active NPI

Robert Y Lee, M.D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1457512071
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036120925 Issued in IL
Practice address
3350 La Jolla Village Drive
San Diego, CA 92161
Phone
(858) 552-8585
Fax
(858) 642-6273
NPI assigned
Jun 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036120925 IL Primary

Addresses

Primary practice location

3350 La Jolla Village Drive
San Diego, CA 92161

Mailing address

3350 La Jolla Village Drive
San Diego, CA 92161
Phone (858) 552-8585

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110519000330 CA Practitioner - Family Practice 9234315607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

9909 Mira Mesa Blvd
Suite 200
San Diego, CA 92131-1061
Phone (858) 657-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
107544CAMDDentist
036120925ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince May 1, 2011 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Family Medicine CurrentSince May 1, 2011 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

9909 Mira Mesa Blvd
Ste 200
San Diego, CA 92131
Phone (858) 657-7750

200 W Arbor Dr
#8201
San Diego, CA 92103
Phone (858) 534-6290

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1457512071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92161",
            "telephone_number": "858-552-8585",
            "fax_number": "858-642-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92161",
            "telephone_number": "858-552-8585",
            "fax_number": "858-642-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ROBERT",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036120925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.