Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 10742 | CA |
NPI | 1003963836 |
---|---|
Provider Name | Cyndi C Lee |
First Address | Stockton, CA 95207-5619 |
Second Address | San Jose, CA 95125-6108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |