Katherine Bao-Shian Lee, M.D., a Professional Corporation

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A120778 Issued in CA

Legal business name

KATHERINE BAO-SHIAN LEE, M.D., A PROFESSIONAL CORPORATION

Doing business as

Halcyon Dermatology

Practice address

24431 Calle de la Louisa
Suite 200
Laguna Hills, CA 92653-7641

Phone

(949) 266-0216

Fax

(949) 266-0216

NPI assigned

Mar 30, 2014

Last updated

Mar 30, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Katherine Lee, M.D.NPI 1265693691

Title

President

Phone

(949) 266-0216

Specialties & licenses 1

Addresses

Other names 1

• Halcyon Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine Bao-Shian Lee, M.D., M.A.

  • Dermatology Physician
  • Laguna Hills, CA
  • NPI 1265693691
  Medicare reassignment Care Compare group NPD Authorized official
• Jeffrey Keith Lander, M.D., PH.D.

  • Dermatology Physician
  • Irvine, CA
  • NPI 1174566046
  Medicare reassignment Care Compare group NPD
• Nancy Ellen Koehler, PA-C

  • Medical Physician Assistant
  • Laguna Niguel, CA
  • NPI 1164543716
  Medicare reassignment
• Astrid Sidarta, PA-C

  • Physician Assistant
  • Burbank, CA
  • NPI 1902924814
  NPD (past)
• Kelly Wong, PA

  • Physician Assistant
  • Laguna Hills, CA
  • NPI 1134825284
  NPD (past)

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

{
    "created_epoch": "1396137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396137600000",
    "number": "1881012656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 TIMBERLAND",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562108",
            "telephone_number": "949-266-0216",
            "fax_number": "949-266-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24431 CALLE DE LA LOUISA",
            "address_2": "SUITE 200",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537641",
            "telephone_number": "949-266-0216",
            "fax_number": "949-266-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE BAO-SHIAN LEE, M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-30",
        "last_updated": "2014-03-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-266-0216",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A120778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halcyon Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dorine Karlin, N.D., L.AC.
• Penny Karr, LCSW LMFT
• Kanchana Karthikeyan
• Sarah Kasman
• Avneesh Katariya, LMFT, MA
• Katherine Manasson MD Inc
• Daniel Katz, M.D.
• Denese Dawn Kaufeldt Montano, P.T.
• Suzanne Helen Kearney
• Keeban Nam, M.D., Inc.

• Dermatology Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.