Timothy Lee, M.D.
Individual provider Active NPI Pediatrics Physician · Stevenson Ranch, CA
NPI 1730216565 · NPPES record last updated Apr 21, 2021
Key facts
- NPI
- 1730216565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A96022 (CA)
- Practice address
- 25407 Hopkins PL
Stevenson Ranch, CA 91381-1424 - Phone
- (213) 265-5775
- NPI assigned
- Feb 28, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080327000353 | CA | Practitioner - Pediatric Medicine | 0749366060 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 96022 | CA | MD | Clinical Social Worker |
| A96022 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current | Accepting new patients | |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current |
Accepting new patients | |
| Healthsorts Supplies LLC | Current | Accepting new patients | |
| West Side Health Care District | Current |
Accepting new patients | |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current |
Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
119 Adkisson Way
Taft, CA 93268
Phone (661) 765-7234
100 E North St
Taft, CA 93268
Phone (661) 765-1935
Interoperability endpoints
- https://api.platform.athenahealth.com/14270/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A96022 | CA | Yes |
Addresses
Primary practice location
25407 Hopkins PL
Stevenson Ranch, CA 91381-1424
Mailing address
25407 Hopkins PL
Stevenson Ranch, CA 91381-1424
Phone (213) 265-5775
Other providers in Stevenson Ranch, CA
- Zachary Dewitt Laird
- Lans ND, Inc
- Thanh Le
- Jey D Lee
- John Jazin Lee
- Tia Littleford
- Rotem Marabella
- Shauneet Marduk
- Valerie Mae Martinez
- Jennifer Anne Moentmann
All providers in Stevenson Ranch, CA · Pediatrics Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.