Active NPI
Peter B Lee, O.D.
- Optometrist
- Redondo Beach, CA
National Provider Identifier
1205166386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10116
- Practice address
- 4518 186TH St
#110
Redondo Beach, CA 90278-4669 - Phone
- (315) 725-3601
- Fax
- (315) 725-5442
- NPI assigned
- Jan 12, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 10116 | CA | Primary |
Addresses
Primary practice location
4518 186TH St
#110
Redondo Beach, CA 90278-4669
Mailing address
Box Number 558
121 Combat Support Hospital
Apo, AP 96205-5244
Phone (315) 725-3601
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10116 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263254400000",
"number": "1205166386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "BOX NUMBER 558",
"address_2": "121 COMBAT SUPPORT HOSPITAL",
"city": "APO",
"state": "AP",
"postal_code": "962055244",
"telephone_number": "315-725-3601",
"fax_number": "315-725-5442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4518 186TH ST",
"address_2": "#110",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902784669",
"telephone_number": "315-725-3601",
"fax_number": "315-725-5442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "PETER",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-12",
"last_updated": "2010-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.