Kristen Lee OD, a Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

13040T Issued in CA

Legal business name

KRISTEN LEE OD, A PROFESSIONAL CORPORATION

Practice address

21739 Avalon Blvd
Carson, CA 90745-3302

Phone

(310) 513-6900

Fax

(310) 513-1445

NPI assigned

Feb 21, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kristen A Lee, O.D.NPI 1972512127

Title

Optometrist/President

Phone

(310) 513-6900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristen Ann Lee, O.D.

  • Optometrist
  • Carson, CA
  • NPI 1972512127
  Medicare reassignment NPD Authorized official
• Mark Malit, O.D.

  • Optometrist
  • El Monte, CA
  • NPI 1942681424
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1023315447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21739 AVALON BLVD",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453302",
            "telephone_number": "310-513-6900",
            "fax_number": "310-513-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21739 AVALON BLVD",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453302",
            "telephone_number": "310-513-6900",
            "fax_number": "310-513-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTEN LEE OD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-21",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "310-513-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13040T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Len Kirkendall
• Jennifer Gage Knapp
• Jacqueline L Kogan, NBC-HWC
• Namie Kong, DMD
• Ethan M Kreiswirth, MA, ATC
• Hong Kang Ku, O.D.
• Ky Dental Professional Corporation
• Verock Ky, DDS
• La Sleep Med Center
• Jenifer B. Labrador, DDS

• Optometrist in Carson, CA
• Providers in Carson, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.