Provider Demographics
NPI:1558526988
Name:SHAW, MINH LE (OD)
Entity Type:Individual
Prefix:DR
First Name:MINH
Middle Name:LE
Last Name:SHAW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3201 OVERLAND AVE
Mailing Address - Street 2:APT # 7137
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-4574
Mailing Address - Country:US
Mailing Address - Phone:714-598-8011
Mailing Address - Fax:
Practice Address - Street 1:855 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-1938
Practice Address - Country:US
Practice Address - Phone:626-305-9100
Practice Address - Fax:626-305-9150
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13540T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist