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General NPI Number Information
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NPI Number | 1447653563
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Entity Type | Organization
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Legal Business Name | SARAH LEE OD, PC
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 330 VIA LAS BRISAS UNIT 140
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City | NEWBURY PARK
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State | CA
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Zip | 91320-7033
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Country | US
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Telephone | 805-498-7209
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Fax |
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Provider Business Mailing Address
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Address Line | 330 VIA LAS BRISAS UNIT 140
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City | NEWBURY PARK
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State | CA
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Zip | 91320-7033
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARAH LEE
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Credential | O.D.
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Telephone | 805-498-7209
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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 | 13537TLG
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License Number State | CA
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