Provider Demographics
NPI:1134301591
Name:LEE-YIP, THERESA M (OD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:M
Last Name:LEE-YIP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1673 BRANHAM LN
Mailing Address - Street 2:SUITE E-156
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-5211
Mailing Address - Country:US
Mailing Address - Phone:408-244-8700
Mailing Address - Fax:
Practice Address - Street 1:1101 S WINCHESTER BLVD
Practice Address - Street 2:SUITE E-156
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3901
Practice Address - Country:US
Practice Address - Phone:408-244-8700
Practice Address - Fax:408-244-9560
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13484T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist