Individual provider Active NPI

Enoch Damin Lee

  • Physician Assistant
  • Sunnyvale, CA
National Provider Identifier
1679439350
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA67758 Issued in CA
Practice address
201 Old San Francisco Rd
Sunnyvale, CA 94086-6385
Phone
(408) 730-4256
NPI assigned
Dec 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA67758 CA Primary

Addresses

Primary practice location

201 Old San Francisco Rd
Sunnyvale, CA 94086-6385

Mailing address

201 Old San Francisco Rd
Sunnyvale, CA 94086-6385

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260428003173 CA Practitioner - Physician Assistant 2365919248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

123 S San Mateo Dr
San Mateo, CA 94401-3804
Phone (650) 343-4200

1720 El Camino Real
Burlingame, CA 94010-3225

50 S San Mateo Dr
San Mateo, CA 94401-3857
Phone (650) 652-8500

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA67758CAMDPhysician Assistant

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1766707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1679439350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OLD SAN FRANCISCO RD",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940866385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OLD SAN FRANCISCO RD",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940866385",
            "telephone_number": "408-730-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ENOCH",
        "middle_name": "DAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-26",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.