Elizabeth Soobin Lee

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64578 Issued in CA

Practice address

1414 S Grand Ave Ste 380
Los Angeles, CA 90015-3072

Phone

(213) 745-6047

NPI assigned

Jul 15, 2022

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Community ClinicGroup PAC ID 5193710275, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Northeast Community Clinic

  dba Wilmington Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Wilmington, CA
  • NPI 1700097540
  Medicare reassignment Care Compare group
• Northeast Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
  • NPI 1275226334
  NPD
• Northeast Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
  • NPI 1891028171

  Physician Assistant

  NPD

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1649904442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 CAMDEN PL",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE STE 380",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153072",
            "telephone_number": "213-745-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ELIZABETH",
        "middle_name": "SOOBIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Lee, PHARM.D.
• Elissa Lee
• Elizabeth Lee
• Elizabeth Ann Lee
• Elizabeth Lisa Lee, DO
• Emily Lee, DDS
• Eric Anthony Lee, MD
• Eric Christopher Lee, DPT
• Eric Jaewon Lee, MD
• Eric Kyle Lee, MD

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.