Active NPI
Hyuntaek Lee
- Speech-Language Pathologist
- Anaheim, CA
National Provider Identifier
1609451400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 17129
- Practice address
- 1360 S Anaheim Blvd Ste 150
Anaheim, CA 92805-6205 - Phone
- (714) 776-1231
- NPI assigned
- Mar 12, 2021
- Last updated
- Jan 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | |||
| Speech-Language Pathologist | 235Z00000X | 17129 | CA | Primary |
Addresses
Primary practice location
1360 S Anaheim Blvd Ste 150
Anaheim, CA 92805-6205
Mailing address
1360 S Anaheim Blvd Ste 150
Anaheim, CA 92805-6205
Phone (714) 776-1231
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17129 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1609451400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1360 S ANAHEIM BLVD STE 150",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928056205",
"telephone_number": "714-776-1231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1360 S ANAHEIM BLVD STE 150",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928056205",
"telephone_number": "714-776-1231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "HYUNTAEK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-12",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "17129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.