Provider Demographics
NPI:1871014753
Name:LEE, ANNIE CHEN (OD)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:CHEN
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:LEE KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:729 MISSION ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-3072
Mailing Address - Country:US
Mailing Address - Phone:626-441-5300
Mailing Address - Fax:626-441-2880
Practice Address - Street 1:729 MISSION ST STE 200
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-3072
Practice Address - Country:US
Practice Address - Phone:626-441-5300
Practice Address - Fax:626-441-2880
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33739152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty