Organization
MANTECA OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEANNE LEE O.D. (PARTNER)
(209) 239-3504
Entity
Organization
Contact information
Practice address
158 N MAPLE AVE, MANTECA, CA 95336-4503
(209) 239-3504
(209) 239-0741
Mailing address
1532 BENNINGTON CT, STOCKTON, CA 95209-4556
(209) 477-3888
Taxonomy
Speciality
Code
Description
License number
State
152WP0200X
Pediatric Optometrist
Primary
12388T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982704979
MY NPI NUMBER
CA
Enumeration date
11/07/2006
Last updated
08/22/2020
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