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

Jisoo Lee, PA

Individual provider Physician Assistant · NPI 1891456885

Jisoo Lee, PA is a Physician Assistant in Irvine, California. Qualified in 2021, 5 years ago. Practices with Sandeep Thakkar DO a Professional Corporation, a 4-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2022
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

16405 Sand Canyon Ave Ste 265
Irvine, CA 92618-3792
Phone: (714) 602-9891
Fax: (714) 912-4181
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA60693 (CA)

Record details

NPI number1891456885
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 3, 2022
Last updated in NPPESFebruary 28, 2025
Certification dateFebruary 28, 2025
Mailing address16405 Sand Canyon Ave Ste 265, Irvine, CA 92618-3792

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Sandeep Thakkar Do A Professional Corporation — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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