Provider Demographics
NPI:1285203851
Name:DR.J LEE, OPTOMETRIST , A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DR.J LEE, OPTOMETRIST , A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:562-587-0337
Mailing Address - Street 1:5100 ORANGETHORPE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1187
Mailing Address - Country:US
Mailing Address - Phone:562-246-9399
Mailing Address - Fax:562-246-9398
Practice Address - Street 1:5100 ORANGETHORPE AVE STE B
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1187
Practice Address - Country:US
Practice Address - Phone:562-246-9399
Practice Address - Fax:562-246-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty