Provider Demographics
NPI:1720121247
Name:LEE, YUSON (OD)
Entity type:Individual
Prefix:DR
First Name:YUSON
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3337 E ROSEDALE LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-2889
Mailing Address - Country:US
Mailing Address - Phone:714-289-9604
Mailing Address - Fax:
Practice Address - Street 1:8901 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1213
Practice Address - Country:US
Practice Address - Phone:714-530-1001
Practice Address - Fax:714-530-1289
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10822T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist