Jeffrey Chung Lee, M.D.
Individual provider Active NPI Pediatrics Physician · Cudahy, CA
NPI 1831402833 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1831402833
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A118296 (CA)
- Practice address
- 7825 Atlantic Ave
Cudahy, CA 90201-5022 - Phone
- (888) 576-6225
- NPI assigned
- Jul 19, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
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 |
|---|---|---|---|---|
| I20140121000779 | CA | Practitioner - Pediatric Medicine | 5092943068 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A118296 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Permanente Medical Group Inc | Pediatrics | Current |
Accepting new patients |
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients |
Locations
3400 Delta Fair Blvd
Antioch, CA 94509
Phone (925) 779-5000
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000
501 J St
Sacramento, CA 95814
Phone (916) 497-3000
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A118296 | CA | Yes |
Addresses
Primary practice location
7825 Atlantic Ave
Cudahy, CA 90201-5022
Mailing address
7825 Atlantic Ave
Cudahy, CA 90201-5022
Phone (888) 576-6225
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Cudahy, CA
- Kaiser Foundation Health Plan Inc
- In Kook Kim
- Cheryl Y. Kono
- Laarni Gutierrez-Darvin MD Inc
- Ladan Zinati DDS Inc
- Jenny Lin
- Joshlynn Marie Lopez
- Lourdes G Bahamonde DO Inc
- Lovato Family Optometric Center, Inc.
- Victoria Ann Lovato
All providers in Cudahy, 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 Nov 29, 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.