Kyung Ah Lee

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95015267 Issued in CA

Practice address

1183 E Foothill Blvd Ste 135
Upland, CA 91786-4082

Phone

(909) 931-1368

Fax

(909) 931-1372

NPI assigned

Nov 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1972104453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W VALENCIA DR SPC 1",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928333320",
            "telephone_number": "562-290-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD STE 135",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864082",
            "telephone_number": "909-931-1368",
            "fax_number": "909-931-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KYUNG",
        "middle_name": "AH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95015267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric C Lee, M.D.
• Grace Lee, M.D.
• Jason S Lee, DDS
• Josephine Lee
• Justin Lee
• Patricia W Lee, M.D.
• Sean Cecil Lee, D.D.S.
• Stephanie Lee
• Thomas Way Lee, MD
• Vincent Gregory Lee, M.D.

• Primary Care Nurse Practitioner in Upland, CA
• Providers in Upland, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.