Individual provider Active NPI

Juhyeong Lee

  • Orthopedic Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1982374062
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
301014 Issued in CA
Practice address
266 S Harvard Blvd Ste 370
Los Angeles, CA 90004
Phone
(213) 908-7065
NPI assigned
Sep 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 301014 CA Primary

Addresses

Primary practice location

266 S Harvard Blvd Ste 370
Los Angeles, CA 90004

Mailing address

266 S Harvard Blvd Ste 370
Los Angeles, CA 90004-3987
Phone (213) 908-7065

Other practice location 1

520 S Virgil Ave Ste 201
Los Angeles, CA 90020-1425
Phone (213) 365-0023

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211015002155 CA Practitioner - Physical Therapist in Private Practice 7719385111 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bom Vichae Physical Therapy Professional CorporationGroup PAC ID 4486013950, 3 clinicians
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

1401 S Brookhurst Rd
Suite 108
Fullerton, CA 92833-4492
Phone (714) 519-3263

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bom Vichae Physical Therapy Professional Corporation Orthopedic CurrentSince Jun 5, 2023 Accepting new patients
Choice Physical Therapy & Rehab PC Orthopedic CurrentSince Oct 15, 2021 Accepting new patients
Ryu Physical Therapy, PC CurrentSince Oct 15, 2021 Accepting new patients
California Luna Care Physical Therapy PC Orthopedic CurrentSince Feb 28, 2023 Accepting new patients

Locations

1441 Brea Blvd
Ste B
Fullerton, CA 92835
Phone (714) 519-3012

1401 S Brookhurst Rd
Ste 108
Fullerton, CA 92833
Phone (714) 392-0876

266 S Harvard Blvd
Ste 370
Los Angeles, CA 90004
Phone (213) 786-1088

520 S Virgil Ave
Ste 201
Los Angeles, CA 90020
Phone (213) 365-0023

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

18771 Colima Rd
Rowland Hghts, CA 91748
Phone (626) 269-0706

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1982374062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 S HARVARD BLVD STE 370",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043987",
            "telephone_number": "213-908-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 S HARVARD BLVD STE 370",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90004",
            "telephone_number": "213-908-7065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 S Virgil Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900201425",
            "country_code": "US",
            "telephone_number": "213-365-0023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JUHYEONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "301014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 20, 2021; 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.