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General NPI Number Information
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NPI Number | 1902089881
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Entity Type | Organization
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Legal Business Name | JEFFREY B. LEE O.D.
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 07/08/2009
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Provider Practice Location Address
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Address Line | 708 W 20TH ST SUITE A
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City | MERCED
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State | CA
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Zip | 95340-3639
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Country | US
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Telephone | 209-384-2335
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Fax | 209-384-2342
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Provider Business Mailing Address
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Address Line | 708 W 20TH ST SUITE A
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City | MERCED
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State | CA
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Zip | 95340-3639
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Country | US
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Telephone | 209-384-2335
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Fax | 209-384-2342
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Authorized Official
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Title or Position | DOCTOR OF OPTOMETRY
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Name | DR. JEFFREY B LEE
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Credential | O.D.
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Telephone | 209-384-2335
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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 | 5423T
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License Number State | CA
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