MEDICARE: LEE H NOVICK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	A068425	CA

General Provider Information

NPI Number	:	1366500456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE H NOVICK M.D.

Provider Business Mailing Address
First Line	:	18837 BROOKHURST ST
Second Line	:	SUITE 110
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-7301
Country	:	US
Telephone Number	:	714-378-0333
Fax Number	:	714-378-0858

Provider Business Practice Location Address
First Line	:	18837 BROOKHURST ST
Second Line	:	STE 110
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-7301
Country	:	US
Telephone Number	:	714-378-0333
Fax Number	:	714-378-0858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	05/06/2008

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