Active NPI
Virginia Wong Lee, O.D.
- Optometrist
- San Jose, CA
National Provider Identifier
1699825216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10665
- Practice address
- 2200 Eastridge Loop
Eastridge Mall Ste 1078
San Jose, CA 95122-1410 - Phone
- (408) 270-6161
- Fax
- (408) 270-6176
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- 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 | 10665 | CA | Primary |
Addresses
Primary practice location
2200 Eastridge Loop
Eastridge Mall Ste 1078
San Jose, CA 95122-1410
Mailing address
6936 Rainbow Dr
San Jose, CA 95129-3748
Phone (408) 255-8442
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 |
|---|---|---|---|
| 10665 | CA | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699825216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6936 RAINBOW DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951293748",
"telephone_number": "408-255-8442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 EASTRIDGE LOOP",
"address_2": "EASTRIDGE MALL STE 1078",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951221410",
"telephone_number": "408-270-6161",
"fax_number": "408-270-6176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "VIRGINIA",
"middle_name": "WONG",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.