Active NPI
Robert James Lee, OD
- Optometrist
- Pomona, CA
National Provider Identifier
1396848792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9856TPG
- Practice address
- 309 E Second Street
Suite 2
Pomona, CA 91766-2007 - Phone
- (909) 706-3899
- Fax
- (909) 469-8640
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 9856TPG | CA | Primary |
Addresses
Primary practice location
309 E Second Street
Suite 2
Pomona, CA 91766-2007
Mailing address
795 E 2ND St
Suite 2
Pomona, CA 91766-2007
Phone (909) 469-8773
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CD430Y | Other | CA | MEDICARE PTAN SO CAL |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9856TPG | CA | MD | Optometrist |
| 9856 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478044800000",
"number": "1396848792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "795 E 2ND ST",
"address_2": "SUITE 2",
"city": "POMONA",
"state": "CA",
"postal_code": "917662007",
"telephone_number": "909-469-8773",
"fax_number": "909-469-5228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E SECOND STREET",
"address_2": "SUITE 2",
"city": "POMONA",
"state": "CA",
"postal_code": "917662007",
"telephone_number": "909-706-3899",
"fax_number": "909-469-8640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ROBERT",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2016-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9856TPG",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN SO CAL",
"identifier": "CD430Y",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.