Individual provider Active NPI

Chin Lee, MD

  • Family Medicine Physician
  • Harbor City, CA
National Provider Identifier
1710054606
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A39014 Issued in CA
Practice address
1403 Lomita Blvd Ste 100
Harbor City, CA 90710
Phone
(310) 784-5800
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A39014 CA Primary

Addresses

Primary practice location

1403 Lomita Blvd Ste 100
Harbor City, CA 90710

Mailing address

2550 W Main St
Alhambra, CA 91801-1694
Phone (626) 457-6900

Other practice location 1

1403 Lomita Blvd Ste 103
Harbor City, CA 90710-2084
Phone (310) 784-1800

Other identifiers 2

IdentifierTypeStateIssuer
MD60074961OtherWALICENSE
2002003MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A39014CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1710054606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W MAIN ST",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011694",
            "telephone_number": "626-457-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 LOMITA BLVD STE 100",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "90710",
            "telephone_number": "310-784-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 Lomita Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Harbor City",
            "state": "CA",
            "postal_code": "907102084",
            "country_code": "US",
            "telephone_number": "310-784-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A39014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD60074961",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002003",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

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

Verify at the official NPI Registry.