Organization Active NPI

Leslie Lee, M.D., a Professional Medical Corporation

  • Internal Medicine Physician
  • Alhambra, CA
National Provider Identifier
1912052275
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LESLIE LEE, M.D., A PROFESSIONAL MEDICAL CORPORATION
Practice address
150 S Raymond Ave
Alhambra, CA 91801-3166
Phone
(626) 300-0008
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Authorized official

Name
Dr. Leslie Lee, M.D.NPI 1790830156
Title
Owner
Phone
(626) 300-0008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X A062246 CA

Addresses

Primary practice location

150 S Raymond Ave
Alhambra, CA 91801-3166

Mailing address

150 S Raymond Ave
Alhambra, CA 91801-3166
Phone (626) 300-0008

Other identifiers 1

IdentifierTypeStateIssuer
W16871AOtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000934 CA Part B Supplier - Clinic/Group Practice 8123913548 Receives reassigned benefits from 1 practitioner
Practice locations: Alhambra, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0956406Leslie Lee MD a Professional Medical Corp150 S Raymond Ave, Alhambra, CA 91801Certificate of waiverJan 26, 2027

National Provider Directory

National Provider Directory

Locations

150 S Raymond Ave
Alhambra, CA 91801
Phone (626) 300-0008

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1912052275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S RAYMOND AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013166",
            "telephone_number": "626-300-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S RAYMOND AVE",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013166",
            "telephone_number": "626-300-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE LEE, M.D., A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-300-0008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A062246",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "W16871A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.