Individual
DR. FANNY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1026 W WEST COVINA PKWY STE B, WEST COVINA, CA 91790-8212
(626) 962-5868
Mailing address
1026 W WEST COVINA PKWY STE B, WEST COVINA, CA 91790-8212
(626) 962-5868
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11688
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0116880
—
CA
Enumeration date
08/30/2005
Last updated
12/01/2022
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