Provider Demographics
NPI:1679660724
Name:SZETO, LYNN KAE (OD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:KAE
Last Name:SZETO
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 1:8450 VALLEY BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1680
Mailing Address - Country:US
Mailing Address - Phone:626-280-6212
Mailing Address - Fax:
Practice Address - Street 1:8450 VALLEY BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1680
Practice Address - Country:US
Practice Address - Phone:626-280-6212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10252TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0102520Medicaid
CAOP10252Medicare ID - Type UnspecifiedMEDIICARE PROVIDER NUMBER
CASD0102520Medicaid