Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ellen Kyungchae Lee, PA

Individual provider Physician Assistant · NPI 1962046714

Ellen Kyungchae Lee, PA is a Physician Assistant in Santa Monica, California. Qualified in 2019, 7 years ago. Practices with Daniel Behroozan MD a Medical Corporation, a 5-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2019
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2221 Lincoln Blvd Ste 100
Santa Monica, CA 90405-1320
Phone: (310) 392-1111
Fax: (310) 392-1101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9090 Burton Way, Beverly Hills, CA 90211-1661 — (310) 392-1111

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1962046714
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 5, 2019
Last updated in NPPESOctober 20, 2025
Certification dateOctober 20, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Daniel Behroozan Md A Medical Corporation — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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