Chan Woo Lee Medical, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A89666 Issued in CA

Legal business name

CHAN WOO LEE MEDICAL, INC.

Practice address

9240 Garden Grove BL.
Suite 2
Garden Grove, CA 92844-1400

Phone

(714) 636-1412

Fax

(714) 530-3100

NPI assigned

Nov 3, 2006

Last updated

Aug 22, 2020By 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. Chan Woo Lee, M.D.NPI 1104909357

Title

President

Phone

(714) 636-1412

Specialties & licenses 1

Addresses

Locations

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.

• Chan Woo Lee, MD

  • General Practice Physician
  • Bakersfield, CA
  • NPI 1104909357
  NPD Authorized official

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700965365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9240 GARDEN GROVE BL.",
            "address_2": "SUITE 2",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441400",
            "telephone_number": "714-636-1412",
            "fax_number": "714-530-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 GARDEN GROVE BL.",
            "address_2": "SUITE 2",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441400",
            "telephone_number": "714-636-1412",
            "fax_number": "714-530-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAN WOO LEE MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHAN",
        "authorized_official_middle_name": "WOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-636-1412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A89666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• In Hwa Chae, MS, OTR/L
• Chaewon Song, MD, Inc
• Heba Chakoukani Jubran, PHARMD
• Stacey Chambers, MSW, MPH, ASW
• Chan Woo Lee Medical Inc. (Pinebrook Medical Clinic)
• Alex Chan
• David Mathias Chan, L. AC.
• Gary Chan
• Jennifer Nguyen Chan, D.O.
• Jonathan Chan, DPT

• Clinic/Center in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.