Provider Demographics
NPI:1144210980
Name:LEE, LUANN S (OD)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7075 N SHARON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3329
Mailing Address - Country:US
Mailing Address - Phone:559-486-2000
Mailing Address - Fax:559-256-8575
Practice Address - Street 1:7075 N SHARON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3329
Practice Address - Country:US
Practice Address - Phone:559-486-2000
Practice Address - Fax:559-256-8575
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT12118T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist