Individual provider Active NPI

Myung Hoon Lee, MD

  • Family Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1821175811
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A45901 Issued in CA
Practice address
14600 Sherman Way Ste 300
Van Nuys, CA 91405-2272
Phone
(818) 787-4770
Fax
(818) 787-2700
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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 A45901 CA Primary

Addresses

Primary practice location

14600 Sherman Way Ste 300
Van Nuys, CA 91405-2272

Mailing address

14614 Victory Blvd
Van Nuys, CA 91411-1621
Phone (818) 787-4770

Other identifiers 1

IdentifierTypeStateIssuer
00A459011MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100527000602 CA Practitioner - Family Practice 1052440112 Reassigns benefits to 1 organization
Practice locations: Van Nuys, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Dec 6, 2021 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 6, 2021 Accepting new patients
Ae Urgent Care - Van Nuys PastSince Apr 1, 2022 Accepting new patients
Victory Medical Clinic Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

14600 Sherman Way
Ste 300
Van Nuys, CA 91405
Phone (818) 208-7138

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1821175811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14614 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621",
            "telephone_number": "818-787-4770",
            "fax_number": "818-787-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14600 SHERMAN WAY STE 300",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052272",
            "telephone_number": "818-787-4770",
            "fax_number": "818-787-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MYUNG",
        "middle_name": "HOON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A45901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A459011",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.