PHILLIP H A LEE MD AND CENTER FOR ADVANCED DERMATOLOGY (NPI# 1124497524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124497524 |
| Entity Type | Organization |
| Organization Name | PHILLIP H A LEE MD AND CENTER FOR ADVANCED DERMATOLOGY |
| Other Organization Name | GLENDALE LASER AND DERMATOLOGY ASSOCIATES |
| Practice Address |
1510 S Central Ave Ste 470 Glendale CA 91204-2514 |
| Practice Telephone | 8182420035 |
| Practice Fax Number | 8182423628 |
| Mailing Telephone | 8182420035 |
| Mailing Fax Number | 8182423628 |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2016-02-19 |
| Authorized Official Name | DR. PHILLIP H A LEE (PRESIDENT) |
| Authorized Official Telephone | 8182420035 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| GLENDALE LASER AND DERMATOLOGY ASSOCIATES | Doing Business As Name - Organization |
| Street Address |
1510 S CENTRAL AVE STE 470 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91204-2514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295871358 | John J Guagenti | Specialist | 1510 S Central Ave Ste 470, Glendale, CA 91204-2514 | 2007-01-29 |
| 1497969067 | Anne Ya Ping Lee | Physician Assistant | 1510 S Central Ave Ste 470, Glendale, CA 91204-2514 | 2007-05-10 |
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| 1538633136 | Pathology La Inc. | Clinical Medical Laboratory | 4634 San Fernando Rd., Same As Above, Glendale, CA 91204 | 2019-01-16 |
| 1295254050 | Glendale Back and Pain Center | Neurological Surgery | 710 S. Central Ave, Suite 240, Glendale, CA 91204 | 2017-09-13 |
| 1285163568 | Ez Trans, Inc. | Transportation Broker | 1626 S. Central Ave., Glendale, CA 91204 | 2017-06-08 |
| 1194254474 | Jenny Chung | Pharmacist | 3943 San Fernando Road, Glendale, CA 91204 | 2017-06-08 |
| 1396111886 | Fresenius Medical Care Glendale, LLC | Clinic/Center | 623 S Central Ave, Glendale, CA 91204 | 2015-08-19 |
| 1710302450 | New Age Foot and Ankle Podiatry PC | Podiatrist | 705 Ivy Street, Glendale, CA 91204 | 2014-03-04 |
| 1124454376 | Alber K. Karamanoukian Medical Clinic, Inc. | Clinic/Center | 810 S. Central Avenue, Suite 100, Glendale, CA 91204 | 2013-09-19 |
| 1548521156 | Glendale Plastic and Reconstructive Surgery Inc. | Plastic Surgery | 1500 S. Central Ave. #126, Glendale, CA 91204 | 2012-05-31 |
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| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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|---|---|---|---|---|
| 1730510785 | Otilia Muresan | Preferred Provider Organization | 22365 N 69th Ave, Glendale, AZ 85310 | 2013-12-02 |
| 1497028534 | Medirect, Inc. | Preferred Provider Organization | 412 W Broadway Ste 210, Glendale, CA 91204-1297 | 2012-02-21 |
| 1407177785 | Californiacarecorp | Preferred Provider Organization | 127 S Brand Blvd # 241, Glendale, CA 91204-1342 | 2010-06-21 |
| 1770801227 | California Care Corp | Preferred Provider Organization | 610 N Central Ave Ste 106, Glendale, CA 91203-1418 | 2010-05-07 |
| 1023284072 | Simply Dental | Preferred Provider Organization | 10646 N 51st Ave, Glendale, AZ 85304-4343 | 2008-04-30 |
| 1962673574 | First Assist, PC | Preferred Provider Organization | 5922 W Yucca St, Glendale, AZ 85304-3776 | 2008-03-23 |
| 1184773889 | Aturning Point for Arizona's Children | Preferred Provider Organization | 4541 W Cheryl Dr, Glendale, AZ 85302-1913 | 2007-01-10 |
| 1265944136 | Sports Champs Inc. | Preferred Provider Organization | 3600 N Verdugo Rd, Glendale, CA 91208-1219 | 2017-10-31 |
| 1295280014 | Reel Dentistry Pllc | Preferred Provider Organization | 5700 W Olive Ave, Suite #104, Glendale, AZ 85302-3147 | 2016-08-22 |
| 1861872566 | P.c. Medical Clinic | Preferred Provider Organization | 631 E Colorado St, Suite C, Glendale, CA 91205 | 2015-06-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.