Provider Demographics
NPI:1497778211
Name:YE, PING (OD)
Entity Type:Individual
Prefix:
First Name:PING
Middle Name:
Last Name:YE
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 1:4521 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3302
Mailing Address - Country:US
Mailing Address - Phone:818-636-1520
Mailing Address - Fax:
Practice Address - Street 1:140 W VALLEY BLVD STE 115
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3784
Practice Address - Country:US
Practice Address - Phone:626-288-8023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12875T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP12875AMedicare ID - Type UnspecifiedPPIN #
CAV06530Medicare UPIN