Individual provider Active NPI

Michael S Lee, MD

  • Emergency Medicine Physician
  • Lynwood, CA
National Provider Identifier
1992733943
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A91019 Issued in CA
Practice address
3630 East Imperial Highway
Lynwood, CA 90262-2678
Phone
(310) 900-8900
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A91019 CA Primary

Addresses

Primary practice location

3630 East Imperial Highway
Lynwood, CA 90262-2678

Mailing address

PO Box 12110
Westminster, CA 92685-2110
Phone (562) 809-3571

Other identifiers 1

IdentifierTypeStateIssuer
00A910190MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050730000124 CA Practitioner - Emergency Medicine 6002844123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intercommunity Emergency Medical GroupGroup PAC ID 7911892534, 60 clinicians

Practice addresses (Care Compare)

12401 Washington Blvd
Whittier, CA 90602-1006
Phone (562) 698-0811

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A91019CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intercommunity Emergency Medical Group Emergency Medicine CurrentSince Mar 1, 2013 Accepting new patients
Mountain View Emergency Physicians Medical Group, Inc. Emergency Medicine CurrentSince May 1, 2016 Accepting new patients
Front Line Emergency Care Spec Emergency Medicine Past Accepting new patients

Locations

11500 Brookshire Ave
Downey, CA 90241
Phone (562) 904-5000

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1992733943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12110",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852110",
            "telephone_number": "562-809-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 EAST IMPERIAL HIGHWAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622678",
            "telephone_number": "310-900-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A91019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A910190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.