Individual provider Active NPI

George C Lee Jr., M.D.

  • Radiology Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1477816700
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
G13768 Issued in CA
Practice address
1200 North State
CT-2B 300 Lac-Usc
Los Angeles, CA 90033-9985
Phone
(323) 226-6225
Fax
(323) 441-8123
NPI assigned
Jun 21, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X G13768 CA Primary

Addresses

Primary practice location

1200 North State
CT-2B 300 Lac-Usc
Los Angeles, CA 90033-9985

Mailing address

1749 Las Palmitas St
South Pasadena, CA 91030-3530
Phone (323) 259-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G13768CAMDRadiology Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1477816700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 LAS PALMITAS ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303530",
            "telephone_number": "323-259-8811",
            "fax_number": "323-259-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTH STATE",
            "address_2": "CT-2B 300 LAC-USC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900339985",
            "telephone_number": "323-226-6225",
            "fax_number": "323-441-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GEORGE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "G13768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.