Provider Demographics
NPI:1053466656
Name:LIT, WENDY (OD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:LIT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 FALLBROOK AVE STE 190
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-3583
Mailing Address - Country:US
Mailing Address - Phone:818-346-2500
Mailing Address - Fax:818-346-2514
Practice Address - Street 1:6700 FALLBROOK AVE STE 190
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-3583
Practice Address - Country:US
Practice Address - Phone:818-346-2500
Practice Address - Fax:818-346-2514
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9683-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0096830Medicaid
CAWOP9683BMedicare UPIN
CAU24436Medicare UPIN