NPIMap

Organization Active NPI

Superkids Pediatrics

  • Pediatrics Physician
  • Irvine, CA
National Provider Identifier
1992056253
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A97744 Issued in CA
Legal business name
SUPERKIDS PEDIATRICS
Practice address
113 Waterworks Way
Suite 140
Irvine, CA 92618-3167
Phone
(949) 903-9186
NPI assigned
Sep 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Dr. Andrew Bryant Lee, M.D.
Title
President
Phone
(949) 903-9186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A97744 CA Primary

Addresses

Primary practice location

113 Waterworks Way
Suite 140
Irvine, CA 92618-3167

Mailing address

113 Waterworks Way
Suite 140
Irvine, CA 92618-3167
Phone (949) 903-9186

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1992056253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY",
            "address_2": "SUITE 140",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183167",
            "telephone_number": "949-903-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY",
            "address_2": "SUITE 140",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183167",
            "telephone_number": "949-903-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERKIDS PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "BRYANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-903-9186",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A97744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.