Sun Ik Lee MD Inc a Professional Medical Corporation

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

SUN IK LEE MD INC A PROFESSIONAL MEDICAL CORPORATION

Practice address

4016 Dale Rd
Modesto, CA 95356-9268

Phone

(209) 571-2088

NPI assigned

Sep 6, 2023

Last updated

Nov 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sun Ik Lee, MDNPI 1376804757

Title

Staff Physician

Phone

(209) 571-0288

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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.

• Sun Ik Lee, MD

  • Neurological Surgery Physician
  • Modesto, CA
  • NPI 1376804757
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1649056466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36833",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151210",
            "telephone_number": "209-571-0288",
            "fax_number": "209-571-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 DALE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569268",
            "telephone_number": "209-571-2088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953504404",
            "country_code": "US",
            "telephone_number": "209-578-1211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUN IK LEE MD INC A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SUN IK",
        "authorized_official_title_or_position": "STAFF PHYSICIAN",
        "authorized_official_telephone_number": "209-571-0288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Bradley Summers, M.D.
• Summit Medical Transport
• Summit Surgery Center Modesto, Inc
• Zarchi E Sumon, M.D.
• Heather J Sumpter
• Chelsea Sun
• Penghan Sun
• Tong Sun, MD
• Mathuran Sundaramoorthy
• Zahara Sundermeyer, NMD

• Neurological Surgery Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.