Active NPI
Edwin Randall Lee, M.D.
- Anesthesiology Physician
- Fremont, CA
National Provider Identifier
1710996160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G58886
- Practice address
- 2000 Mowry Ave
Fremont, CA 94538-1716 - Phone
- (510) 797-1111
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G58886 | CA | Primary |
Addresses
Primary practice location
2000 Mowry Ave
Fremont, CA 94538-1716
Mailing address
PO Box V
Mountain View, CA 94040-0150
Phone (650) 691-0611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G588860 | Medicaid | CA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern California Anesthesia Associates | Anesthesiology | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- Fremont, CA
- NPI 1740299080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248048000000",
"number": "1710996160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX V",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940400150",
"telephone_number": "650-691-0611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 MOWRY AVE",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381716",
"telephone_number": "510-797-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "EDWIN",
"middle_name": "RANDALL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2009-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G58886",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G588860",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.