Healthcare Provider Details

I. General information

NPI: 1073102471
Provider Name (Legal Business Name): LEE OPTOMETRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E CYPRESS AVE
REDDING CA
96002-0105
US

IV. Provider business mailing address

PO BOX 2810
OROVILLE CA
95965-2810
US

V. Phone/Fax

Practice location:
  • Phone: 530-722-9992
  • Fax: 530-722-9997
Mailing address:
  • Phone: 530-990-9207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MAGGI LEE
Title or Position: CEO
Credential: OD
Phone: 530-990-9207