Provider Demographics
NPI:1164036646
Name:DR.JULIANE LEE,OPTOMETRIST, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DR.JULIANE LEE,OPTOMETRIST, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:OZUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-674-8806
Mailing Address - Street 1:14309 BEAR VALLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-7648
Mailing Address - Country:US
Mailing Address - Phone:760-674-8806
Mailing Address - Fax:
Practice Address - Street 1:14309 BEAR VALLEY RD STE B
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-7648
Practice Address - Country:US
Practice Address - Phone:760-674-8806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty