Active NPI
Lee S Austin, MD
- Dermatology Physician
- Rancho Cucamonga, CA
National Provider Identifier
1982702429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G43777
- Practice address
- 7365 Carnelian St
Ste 137
Rancho Cucamonga, CA 91730-1100 - Phone
- (909) 948-8888
- Fax
- (909) 948-8839
- NPI assigned
- Sep 20, 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G43777 | CA | Primary |
Addresses
Primary practice location
7365 Carnelian St
Ste 137
Rancho Cucamonga, CA 91730-1100
Mailing address
7365 Carnelian St
Ste 137
Rancho Cucamonga, CA 91730-1100
Phone (909) 948-8888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G437770 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43777 | CA | MD | Dentist |
| G43777 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303344000000",
"number": "1982702429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7365 CARNELIAN ST",
"address_2": "STE 137",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917301100",
"telephone_number": "909-948-8888",
"fax_number": "909-948-8839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7365 CARNELIAN ST",
"address_2": "STE 137",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917301100",
"telephone_number": "909-948-8888",
"fax_number": "909-948-8839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "LEE",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2011-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G43777",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G437770",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.