NPIMap

Organization Active NPI

Hyo Soo Lee

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1851495808
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY41635 Issued in CA
Legal business name
HYO SOO LEE
Doing business as
WILSHIRE PHARMACY
Practice address
2013 Wilshire Blvd
Los Angeles, CA 90057-3503
Phone
(213) 483-8025
Fax
(213) 483-2640
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Authorized official

Name
Hyo Soo Lee
Title
Owner/President
Phone
(213) 483-8025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY41635 CA Primary

Addresses

Primary practice location

2013 Wilshire Blvd
Los Angeles, CA 90057-3503

Mailing address

2013 Wilshire Blvd
Los Angeles, CA 90057-3503
Phone (213) 483-8025

Other identifiers 2

IdentifierTypeStateIssuer
PHA416350MedicaidCA
0543505OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • WILSHIRE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

2013 Wilshire Blvd
Los Angeles, CA 90057
Phone (213) 483-8025

Practitioners & affiliated clinicians

Practitioners 1

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1851495808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573503",
            "telephone_number": "213-483-8025",
            "fax_number": "213-483-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573503",
            "telephone_number": "213-483-8025",
            "fax_number": "213-483-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYO SOO LEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "SOO LEE",
        "authorized_official_first_name": "HYO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "213-483-8025"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY41635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA416350",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0543505",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILSHIRE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.