Provider Demographics
NPI:1679071930
Name:TSENG, LAWRENCE WEI (OD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:WEI
Last Name:TSENG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15680 DILL LN
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-5482
Mailing Address - Country:US
Mailing Address - Phone:626-226-9195
Mailing Address - Fax:
Practice Address - Street 1:17264 FOOTHILL BLVD STE E
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-9051
Practice Address - Country:US
Practice Address - Phone:909-355-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33876TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist