Provider Demographics
NPI:1386471993
Name:DR. LEE & LEE OPTOMETRIC PROFESSIONAL CORP.
Entity type:Organization
Organization Name:DR. LEE & LEE OPTOMETRIC PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:P
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:858-451-1250
Mailing Address - Street 1:11972 BERNARDO PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2538
Mailing Address - Country:US
Mailing Address - Phone:619-300-8557
Mailing Address - Fax:858-451-1338
Practice Address - Street 1:11972 BERNARDO PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2538
Practice Address - Country:US
Practice Address - Phone:619-300-8557
Practice Address - Fax:858-451-1338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty