Individual provider Active NPI

Taesung Isaac Lee, PHARMD

  • Pharmacist
  • El Segundo, CA
National Provider Identifier
1831811843
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
86853 Issued in CA
Practice address
331 N Pacific Coast Hwy
El Segundo, CA 90245-4444
Phone
(310) 640-9651
NPI assigned
Sep 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 86853 CA Primary

Addresses

Primary practice location

331 N Pacific Coast Hwy
El Segundo, CA 90245-4444

Mailing address

331 S Pacific Coast Hwy
El Segundo, CA 90245
Phone (310) 640-9651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
86853CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1831811843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 S PACIFIC COAST HWY",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "90245",
            "telephone_number": "310-640-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 N PACIFIC COAST HWY",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454444",
            "telephone_number": "310-640-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "TAESUNG",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "86853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.