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General NPI Number Information
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NPI Number | 1306430384
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Entity Type | Organization
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Legal Business Name | HORIZON OPTOMETRY GROUP, PC
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 9600 BOLSA AVE STE C&H
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City | WESTMINSTER
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State | CA
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Zip | 92683-5949
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Country | US
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Telephone | 714-775-7045
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Fax | 714-775-7050
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Provider Business Mailing Address
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Address Line | 9600 BOLSA AVE STE C&H
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City | WESTMINSTER
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State | CA
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Zip | 92683-5949
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Country | US
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Telephone | 714-775-7045
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Fax | 714-775-7050
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. KELLEE L TEA LE
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Credential | OD
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Telephone | 714-775-7045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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