Provider Demographics
NPI:1467820589
Name:LEE AND WU, OPTOMETRISTS, PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:LEE AND WU, OPTOMETRISTS, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:YUTING
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:619-847-1777
Mailing Address - Street 1:1033 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3515
Mailing Address - Country:US
Mailing Address - Phone:619-477-2771
Mailing Address - Fax:619-477-1680
Practice Address - Street 1:1033 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3515
Practice Address - Country:US
Practice Address - Phone:619-477-2771
Practice Address - Fax:619-477-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-05
Last Update Date:2015-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14743 TLG152W00000X
CA14519 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty