Provider Demographics
NPI:1659827590
Name:ZEELIG, DIANNA LAM (OD)
Entity Type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:LAM
Last Name:ZEELIG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DIANNA
Other - Middle Name:
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:193 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-1114
Mailing Address - Country:US
Mailing Address - Phone:650-521-5440
Mailing Address - Fax:
Practice Address - Street 1:193 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-1114
Practice Address - Country:US
Practice Address - Phone:650-521-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT33426TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist