Active NPI
Chung Min Lee, MD
- Pediatrics Physician
- Hawaiian Gardens, CA
National Provider Identifier
1912075235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A36083
- Practice address
- 12121 E Carsons St
Hawaiian Gardens, CA 90716 - Phone
- (562) 402-1449
- Fax
- (562) 403-4648
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A36083 | CA | Primary |
Addresses
Primary practice location
12121 E Carsons St
Hawaiian Gardens, CA 90716
Mailing address
12121 E Carsons St
Hawaiian Gardens, CA 90716
Phone (562) 402-1449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A360831 | Medicaid | CA |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A36083 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912075235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12121 E CARSONS ST",
"city": "HAWAIIAN GARDENS",
"state": "CA",
"postal_code": "90716",
"telephone_number": "562-402-1449",
"fax_number": "562-403-4648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12121 E CARSONS ST",
"city": "HAWAIIAN GARDENS",
"state": "CA",
"postal_code": "90716",
"telephone_number": "562-402-1449",
"fax_number": "562-403-4648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CHUNG",
"middle_name": "MIN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A36083",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A360831",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hawaiian Gardens, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.