Provider Demographics
NPI:1407239924
Name:LUE SANG, SASHA (OD)
Entity Type:Individual
Prefix:DR
First Name:SASHA
Middle Name:
Last Name:LUE SANG
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 1:15560 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:SUITE B2
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2091
Mailing Address - Country:US
Mailing Address - Phone:480-661-8733
Mailing Address - Fax:480-661-8584
Practice Address - Street 1:15560 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:SUITE B2
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2091
Practice Address - Country:US
Practice Address - Phone:480-661-8733
Practice Address - Fax:480-661-8584
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2062152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist