Active NPI
Alan Irving Lee, MD
- Pediatrics Physician
- San Bernardino, CA
National Provider Identifier
1659497535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A105008
- Practice address
- 1906 Commercenter E Ste 101
San Bernardino, CA 92408-3423 - Phone
- (909) 891-1913
- Fax
- (909) 884-0810
- NPI assigned
- Mar 22, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A105008 | CA | Primary |
Addresses
Primary practice location
1906 Commercenter E Ste 101
San Bernardino, CA 92408-3423
Mailing address
PO Box 9270
Redlands, CA 92375-2470
Phone (951) 779-1670
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A105008 | CA | MD | Pediatrics Physician |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551139200000",
"number": "1659497535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9270",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923752470",
"telephone_number": "951-779-1670",
"fax_number": "951-779-1679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1906 COMMERCENTER E STE 101",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083423",
"telephone_number": "909-891-1913",
"fax_number": "909-884-0810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ALAN",
"middle_name": "IRVING",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2019-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A105008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.