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General NPI Number Information
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NPI Number | 1619720471
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Entity Type | Organization
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Legal Business Name | JOYCE LEE OD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/10/2024
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 3245 SPORTS ARENA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92110-4529
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Country | US
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Telephone | 619-223-1702
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Fax |
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Provider Business Mailing Address
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Address Line | 4466 PHILBROOK SQ
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City | SAN DIEGO
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State | CA
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Zip | 92130-8675
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Country | US
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Telephone | 858-357-7068
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JOYCE LEE
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Credential | OD
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Telephone | 858-357-7068
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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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