Lee, Derron Timothy
Lee, Derron Timothy is an sole proprietor health care provider with primary practice located at 158 N Maple Ave , Manteca CA 95336-4503. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lee, Derron Timothy can be contacted via phone (209) 239-3504.Contact Information
Primary practice address
158 N Maple Ave
Manteca CA 95336-4503
Phone: (209) 239-3504
Fax: (209) 239-0741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 12387T | California |
Profile Details
| NPI number | 1144313552 |
|---|---|
| LBN Legal business name | Lee, Derron Timothy |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 30th, 2006 |
| Last updated | Jul 26th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144313552 | NPPES |
| California | Other | 11620 | MESC |
| California | Other | CA2387 | MESC |
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