NPIMap

Organization Active NPI

Jaehoon Lee Optometry Corp

  • Optometrist
  • Redlands, CA
National Provider Identifier
1407683063
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JAEHOON LEE OPTOMETRY CORP
Practice address
9990 Alabama St Ste B
Redlands, CA 92374-2067
Phone
(909) 372-0280
Fax
(909) 372-0156
NPI assigned
Sep 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Dr. Jaehoon Lee, ODNPI 1174648687
Title
Owner
Phone
(617) 233-4847

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

9990 Alabama St Ste B
Redlands, CA 92374-2067

Mailing address

9990 Alabama St Ste B
Redlands, CA 92374-2067
Phone (909) 372-0280

Other names 1

  • My Eye Guy Optometry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jaehoon Lee Optometry Corp3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1407683063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9990 ALABAMA ST STE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742067",
            "telephone_number": "909-372-0280",
            "fax_number": "909-372-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9990 ALABAMA ST STE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742067",
            "telephone_number": "909-372-0280",
            "fax_number": "909-372-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAEHOON LEE OPTOMETRY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAEHOON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-233-4847",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Eye Guy Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.