Individual provider Active NPI

Kenneth Lee, M.D.

  • Internal Medicine Physician
  • Norwalk, CA
National Provider Identifier
1831149475
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A53421 Issued in CA
Practice address
12360 Firestone Blvd
Norwalk, CA 90650-4324
Phone
(562) 867-7999
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A53421 CA Primary

Addresses

Primary practice location

12360 Firestone Blvd
Norwalk, CA 90650-4324

Mailing address

12360 Firestone Blvd
Norwalk, CA 90650-4324
Phone (562) 867-7999

Other identifiers 1

IdentifierTypeStateIssuer
00A534210MedicaidCA

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
I20120404000231 CA Practitioner - Internal Medicine 6002076726 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A53421CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute, Inc CurrentSince Jun 2, 2025 Accepting new patients
JWCH Institute Inc Current Accepting new patients
JWCH Institute Inc CurrentSince Jun 2, 2025 Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kenneth.leemd.p1@direct.jwch.nextgenshare.com

Organizations & group practices 3

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1831149475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12360 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504324",
            "telephone_number": "562-867-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504324",
            "telephone_number": "562-867-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A53421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A534210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.