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General NPI Number Information
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NPI Number | 1538128582
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Entity Type | Individual
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Provider Name | DAMON LEE O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 26932 LA PAZ RD
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City | ALISO VIEJO
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State | CA
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Zip | 92656-8821
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Country | US
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Telephone | 949-425-1694
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Fax |
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Provider Business Mailing Address
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Address Line | 26932 LA PAZ RD
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3038
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Country | US
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Telephone | 949-425-1694
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 10842T
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License Number State | CA
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