Individual provider Active NPI

Stephen Bumsuk Lee, M.D.

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1467468488
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A65674 Issued in CA
Practice address
42 Paso Robles
Irvine, CA 92602-1091
Phone
(562) 868-0733
Fax
(562) 868-3389
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 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 A65674 CA Primary

Addresses

Primary practice location

42 Paso Robles
Irvine, CA 92602-1091

Mailing address

42 Paso Robles
Irvine, CA 92602-1091
Phone (562) 868-0733

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
I20040331001408 CA Practitioner - Family Practice 2163314972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacqueline B Aguiluz D O IncGroup PAC ID 8022040013, 3 clinicians

Practice addresses (Care Compare)

21508 Norwalk Blvd
Hawaiian Gardens, CA 90716-1122
Phone (562) 865-5214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A65674CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jacqueline B. Aguiluz, D.O. Inc Family Medicine CurrentSince Jul 1, 2005 Accepting new patients
University of California Irvine Past Accepting new patients
Tri-City Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients

Locations

21508 Norwalk Blvd
Hawaiian Gdns, CA 90716
Phone (562) 865-5214

13330 Bloomfield Ave
Ste 111
Norwalk, CA 90650
Phone (562) 868-0733

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1467468488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 PASO ROBLES",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021091",
            "telephone_number": "562-868-0733",
            "fax_number": "562-868-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 PASO ROBLES",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021091",
            "telephone_number": "562-868-0733",
            "fax_number": "562-868-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "STEPHEN",
        "middle_name": "BUMSUK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A65674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.