Martin, Jerry Lee

Martin, Jerry Lee is an individual health care provider with primary practice located at 1745 W Avenue K , Lancaster CA 93534-6502. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Martin, Jerry Lee can be contacted via phone (661) 942-8437.

Contact Information

Primary practice address
1745 W Avenue K Lancaster CA 93534-6502
Phone: (661) 942-8437
Fax: (661) 940-1959
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT6288TPL California
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X OPT6288TPL California

Profile Details

NPI number 1679543821
LBN Legal business name Martin, Jerry Lee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Feb 20th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679543821 NPPES
California Other 6169 MESC PROVIDER NUMBER
California Other ZZ40293Z MESC PROVIDER NUMBER
California Other 2673 MESC PROVIDER NUMBER
California Other 410016191 MESC PROVIDER NUMBER
California Other SD0062880 MESC PROVIDER NUMBER

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