Individual
ELAINE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
19201 BEAR VALLEY RD, APPLE VALLEY, CA 92308-2702
(760) 247-1013
Mailing address
11548 LARK DR, RANCHO CUCAMONGA, CA 91701-9221
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10507T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0105070
—
CA
Enumeration date
09/20/2006
Last updated
05/23/2019
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