Provider Demographics
NPI:1518107341
Name:JEAN YEH OPTOMETRY CORPORATION
Entity Type:Organization
Organization Name:JEAN YEH OPTOMETRY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:909-466-7580
Mailing Address - Street 1:9788 19TH ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-3538
Mailing Address - Country:US
Mailing Address - Phone:909-466-7580
Mailing Address - Fax:
Practice Address - Street 1:9788 19TH ST
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-3538
Practice Address - Country:US
Practice Address - Phone:909-466-7580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT11786T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty