Tae Kyung Lee, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA62289 Issued in CA

Practice address

1211 W la Palma Ave Ste 101
Anaheim, CA 92801-2809

Phone

(714) 527-7000

NPI assigned

Feb 9, 2023

Last updated

Feb 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Terry Lee Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Harishchandra N Patel MD Inc

  • Cardiovascular Disease Physician
  • Anaheim, CA
  • NPI 1679769558
  NPD

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1609573658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012809",
            "telephone_number": "714-527-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012809",
            "telephone_number": "714-527-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "TAE KYUNG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRY",
            "last_name": "LEE",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sul Gi Lee, LCSW 137107
• Sung H Lee, LCSW
• Sungmin Lee, L.AC.
• Susan S Lee, NP
• Suzanne Lee
• Ted Davis Lee
• Theodore F. Lee, MD
• Thomas Chung Kiang Lee, M.D.
• Thomas Hon-Jeh Lee, M.D.
• Urim Audrey Lee, ACSW

• Physician Assistant in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.