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General NPI Number Information
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NPI Number | 1386471993
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Entity Type | Organization
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Legal Business Name | DR. LEE & LEE OPTOMETRIC PROFESSIONAL CORP.
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 11972 BERNARDO PLAZA DR
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City | SAN DIEGO
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State | CA
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Zip | 92128-2538
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Country | US
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Telephone | 619-300-8557
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Fax | 858-451-1338
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Provider Business Mailing Address
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Address Line | 11972 BERNARDO PLAZA DR
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City | SAN DIEGO
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State | CA
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Zip | 92128-2538
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Country | US
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Telephone | 619-300-8557
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Fax | 858-451-1338
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Authorized Official
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Title or Position | OPTOMETRIST/ PRESIDENT
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Name | DR. SUZANNE P LEE
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Credential | OD
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Telephone | 858-451-1250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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