Individual provider Active NPI

Anne Cindy Lee, OD, FAAO

  • Pediatric Optometrist
  • Hawthorne, CA
National Provider Identifier
1366440018
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
13467 Issued in CA
Practice address
13427 Inglewood Ave
Hawthorne, CA 90250-5608
Phone
(310) 676-2020
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 13467 CA Primary
Optometrist 152W00000X 1324 AZ
Optometrist 152W00000X 13467 CA

Addresses

Primary practice location

13427 Inglewood Ave
Hawthorne, CA 90250-5608

Mailing address

1828 Walnut Ave
Manhattan Beach, CA 90266-5019
Phone (917) 554-5336

Other practice location 1

223 Manhattan Beach Blvd
Manhattan Beach, CA 90266-5314
Phone (310) 545-4090

Other practice location 2

1828 Walnut Ave
Manhattan Beach, CA 90266-5019
Phone (917) 554-5336

Other identifiers 1

IdentifierTypeStateIssuer
11423229OtherCAQH UNIVERSAL CREDENTIAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150706000241 CA Practitioner - Optometry 6002885514 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1324AZMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden San Gabriel Optometric Vision Center Optometrist CurrentSince May 16, 2015 Accepting new patients
Total Vision PC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
Semel Vision Care CurrentSince Mar 1, 2018 Accepting new patients
Eye Sight Optician, Inc. Past Accepting new patients
Prime Eye Care PC Optometrist Past Accepting new patients
Paw Optometry Optometrist PastSince Jan 21, 2024 Accepting new patients
John E. Maanum, O.D. Optometrist PastSince May 29, 2022 Accepting new patients
M Alexander Bonakdar OD Inc Optometrist Past Accepting new patients

Locations

390 N Pacific Coast Hwy
Ste 1100
El Segundo, CA 90245
Phone (310) 641-1700

140 W Valley Blvd
Ste 115
San Gabriel, CA 91776
Phone (626) 288-8023

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1366440018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 WALNUT AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665019",
            "telephone_number": "917-554-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13427 INGLEWOOD AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505608",
            "telephone_number": "310-676-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Manhattan Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Manhattan Beach",
            "state": "CA",
            "postal_code": "902665314",
            "country_code": "US",
            "telephone_number": "310-545-4090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1828 Walnut Ave",
            "address_purpose": "LOCATION",
            "city": "Manhattan Beach",
            "state": "CA",
            "postal_code": "902665019",
            "country_code": "US",
            "telephone_number": "917-554-5336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANNE",
        "middle_name": "CINDY",
        "name_prefix": "Dr.",
        "credential": "OD, FAAO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "13467",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1324",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH UNIVERSAL CREDENTIAL",
            "identifier": "11423229",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.