NPIMap

Individual provider Active NPI

Brian M Lee, MD

  • Nephrology Physician
  • Lynwood, CA
National Provider Identifier
1558457556
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A86438 Issued in CA
Practice address
3625 Martin Luther King Jr Blvd
Suite #5
Lynwood, CA 90262-3509
Phone
(310) 763-7504
Fax
(310) 763-7573
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A86438 CA Primary

Addresses

Primary practice location

3625 Martin Luther King Jr Blvd
Suite #5
Lynwood, CA 90262-3509

Mailing address

3625 Martin Luther King Jr Blvd
Suite #5
Lynwood, CA 90262-3509
Phone (310) 763-7504

Other practice location 1

11180 Warner Ave Ste 353
Fountain Valley, CA 92708-7516
Phone (714) 367-4275

Other practice location 2

18785 Brookhurst St Ste 200
Fountain Valley, CA 92708-7300
Phone (714) 367-4275

Other practice location 3

31001 Rancho Viejo Rd Ste 100A
San Juan Capistrano, CA 92675-8704
Phone (714) 367-4275

Other identifiers 1

IdentifierTypeStateIssuer
00A864380MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051021000465 CA Practitioner - NephrologyPractitioner - Internal Medicine 4880610575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Tufts University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3625 Martin Luther King Jr Blvd
Suite 5
Lynwood, CA 90262-3509
Phone (310) 763-7504

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Apr 2, 2013 Accepting new patients
Brian Lee, M.D., Inc. CurrentSince Jul 1, 2008 Accepting new patients
County of Los Angeles CurrentSince Apr 2, 2013 Accepting new patients
Brian M Lee MD Inc Nephrology CurrentSince Jul 1, 2008 Accepting new patients
University of California Irvine Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
St Francis Medical Center Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Southern California Specialty Care, LLC Past Accepting new patients

Locations

1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240

18785 Brookhurst St
Ste 200
Fountain Valley, CA 92708
Phone (714) 378-5330

11180 Warner Ave
Ste 353
Fountain Vly, CA 92708
Phone (714) 751-3540

1670 E 120th St
Los Angeles, CA 90059
Phone (424) 338-1000

3625 Martin Luther King Jr Blvd
Ste 5
Lynwood, CA 90262
Phone (310) 763-7504

3625 Martin Luther King Jr Blvd
Lynwood, CA 90262

16415 Colorado Ave
Ste 410
Paramount, CA 90723
Phone (562) 316-0200

31001 Rancho Viejo Rd
Ste 100A
San Juan Capistrano, CA 92675
Phone (714) 367-4275

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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 11

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1558457556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE #5",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623509",
            "telephone_number": "310-763-7504",
            "fax_number": "310-763-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE #5",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623509",
            "telephone_number": "310-763-7504",
            "fax_number": "310-763-7573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11180 Warner Ave Ste 353",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087516",
            "country_code": "US",
            "telephone_number": "714-367-4275",
            "fax_number": "310-763-7573",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18785 Brookhurst St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087300",
            "country_code": "US",
            "telephone_number": "714-367-4275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31001 Rancho Viejo Rd Ste 100A",
            "address_purpose": "LOCATION",
            "city": "San Juan Capistrano",
            "state": "CA",
            "postal_code": "926758704",
            "country_code": "US",
            "telephone_number": "714-367-4275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRIAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A86438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A864380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.