Active NPI
Andrew Lee, OD
- Optometrist
- Victorville, CA
National Provider Identifier
1891447496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 34879
- Practice address
- 14555 Valley Center Dr
Victorville, CA 92395-4216 - Phone
- (760) 955-8228
- NPI assigned
- Jan 25, 2022
- 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 | 34879 | CA | Primary |
Addresses
Primary practice location
14555 Valley Center Dr
Victorville, CA 92395-4216
Mailing address
5728 Indigo Ave
Rancho Cucamonga, CA 91701-1846
Phone (909) 297-9317
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643068800000",
"number": "1891447496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5728 INDIGO AVE",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917011846",
"telephone_number": "909-297-9317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14555 VALLEY CENTER DR",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923954216",
"telephone_number": "760-955-8228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-25",
"last_updated": "2022-01-25",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "34879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.