Provider Demographics
NPI:1225749096
Name:ANITA LEE, O.D., INC.
Entity Type:Organization
Organization Name:ANITA LEE, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:LYMON OWYANG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-206-9510
Mailing Address - Street 1:615 SEPULVEDA PL
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-4292
Mailing Address - Country:US
Mailing Address - Phone:510-206-9510
Mailing Address - Fax:714-491-7030
Practice Address - Street 1:101 S EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1011
Practice Address - Country:US
Practice Address - Phone:714-491-7036
Practice Address - Fax:714-491-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty