Individual provider Active NPI

Lee Cornforth, O. D.

  • Optometrist
  • Camp Pendleton, CA
National Provider Identifier
1104827203
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1703 Issued in WA
Practice address
Navhosp Camp Pendleton
Camp Pendleton, CA 92055-5191
Phone
(760) 725-1307
NPI assigned
Aug 10, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1703 WA Primary

Addresses

Primary practice location

Navhosp Camp Pendleton
Camp Pendleton, CA 92055-5191

Mailing address

504 W Barnett Cir
Oceanside, CA 92054-8304
Phone (760) 725-1307

Other identifiers 1

IdentifierTypeStateIssuer
1703OtherWAO.D. LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1703WAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104827203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W BARNETT CIR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920548304",
            "telephone_number": "760-725-1307",
            "fax_number": "760-725-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVHOSP CAMP PENDLETON",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-725-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNFORTH",
        "first_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "O.D. LICENSE NUMBER",
            "identifier": "1703",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.