Organization Active NPI

Pen H. Lee, M.D., Inc

  • Primary Care Clinic/Center
  • Monterey Park, CA
National Provider Identifier
1740458868
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PEN H. LEE, M.D., INC
Practice address
600 N Garfield Ave Ste 110
Monterey Park, CA 91754-1168
Phone
(626) 571-6641
Fax
(626) 571-6643
NPI assigned
Feb 11, 2008
Organization subpart
Yes
Parent organization
PEN H. LEE, M.D., INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
Dr. Pen Hong Lee, MD
Title
Managing Physician
Phone
(626) 571-6641

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A44281 CA
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

600 N Garfield Ave Ste 110
Monterey Park, CA 91754-1168

Mailing address

600 N Garfield Ave Ste 110
Monterey Park, CA 91754-1168
Phone (626) 571-6641

Other identifiers 1

IdentifierTypeStateIssuer
GR0092480MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050808000446 CA Part B Supplier - Clinic/Group Practice 2062441389 Receives reassigned benefits from 2 practitioners
Practice locations: Monterey Park, CA

National Provider Directory

National Provider Directory
Part of
Pen H Lee MD Inc

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1740458868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 110",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541168",
            "telephone_number": "626-571-6641",
            "fax_number": "626-571-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 110",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541168",
            "telephone_number": "626-571-6641",
            "fax_number": "626-571-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEN H. LEE, M.D., INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEN H. LEE, M.D., INC",
        "enumeration_date": "2008-02-11",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "PEN",
        "authorized_official_middle_name": "HONG",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "626-571-6641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A44281",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.