Provider Demographics
NPI:1134596273
Name:LEE, JOCELYN MARIE (OD)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:MARIE
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:MARIE
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3727 W 6TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5108
Mailing Address - Country:US
Mailing Address - Phone:213-235-2500
Mailing Address - Fax:213-251-8647
Practice Address - Street 1:3750 W 6TH ST STE 113
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020
Practice Address - Country:US
Practice Address - Phone:213-235-2500
Practice Address - Fax:213-251-8647
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15331152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist