Organization Active NPI

Dong Hyun Lee, MD, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1538723382
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
DONG HYUN LEE, MD, INC.
Practice address
2727 W Olympic Blvd Ste 309
Los Angeles, CA 90006-2699
Phone
(213) 674-7758
Fax
(213) 674-7857
NPI assigned
Apr 26, 2019
Last updated
Sep 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Authorized official

Name
Dong Hyun Lee, MDNPI 1134109200
Title
President
Phone
(714) 504-6404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

2727 W Olympic Blvd Ste 309
Los Angeles, CA 90006-2699

Mailing address

78 Shadywood
Irvine, CA 92620-7203
Phone (714) 504-6404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191204000631 CA Part B Supplier - Clinic/Group Practice 6800229923 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

2727 W Olympic Blvd
Ste 309
Los Angeles, CA 90006
Phone (213) 674-7758

903 Crenshaw Blvd
Ste 103
Los Angeles, CA 90019
Phone (323) 549-0100

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1538723382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 SHADYWOOD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926207203",
            "telephone_number": "714-504-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W OLYMPIC BLVD STE 309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062699",
            "telephone_number": "213-674-7758",
            "fax_number": "213-674-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONG HYUN LEE, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DONG",
        "authorized_official_middle_name": "HYUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-504-6404",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "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 Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.