| Jisoo Lee, PA | |
|
16405 Sand Canyon Ave Ste 265, Irvine, CA 92618-3792 | |
| (714) 602-9891 | |
| (714) 912-4181 |
| Full Name | Jisoo Lee |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 5 Years |
| Location | 16405 Sand Canyon Ave Ste 265, Irvine, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891456885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA60693 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hoag Memorial Hospital Presbyterian | Newport beach, CA | Hospital |
| Providence St. Jude Medical Center | Fullerton, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sandeep Thakkar Do A Professional Corporation | 4688019722 | 4 |
| Entity Name | Sandeep Thakkar DO a Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568150662 PECOS PAC ID: 4688019722 Enrollment ID: O20240228004820 |
| Mailing Address | Practice Location Address |
|---|---|
| Jisoo Lee, PA 16405 Sand Canyon Ave Ste 265, Irvine, CA 92618-3792 Ph: (714) 602-9891 | Jisoo Lee, PA 16405 Sand Canyon Ave Ste 265, Irvine, CA 92618-3792 Ph: (714) 602-9891 |
Mrs. Kelsey Chan, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 14443 Culver Dr Ste A, Irvine, CA 92604 Phone: 949-767-8173 |
Jazmin Alejandra Hiemer, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4212 Archway, Irvine, CA 92618 Phone: 714-814-6560 |
Amanda Erin Feenberg, PA-S Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 9401 Jeronimo Rd, Irvine, CA 92618 Phone: 714-744-7650 |
Fasiha Rashid Memon, Physician Assistant Medicare: Medicare Enrolled Practice Location: 1400 Reynolds Ave Ste 100, Irvine, CA 92614 Phone: 657-900-4536 Fax: 657-208-9732 |
Kim Phan, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4980 Barranca Pkwy Ste 202, Irvine, CA 92604 Phone: 949-733-1336 |
Mohammad Addal, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 81 Visionary, Irvine, CA 92618 Phone: 714-482-7914 |
Marie J. Galvan Renella, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2 Osborn St Ste 180, Irvine, CA 92604 Phone: 949-417-9820 Fax: 949-417-9830 |