Provider Demographics
NPI:1760632772
Name:VIEN, LEE QUIN (OD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:QUIN
Last Name:VIEN
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 1:710 ROCK ROSE WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-1890
Mailing Address - Country:US
Mailing Address - Phone:773-350-7752
Mailing Address - Fax:
Practice Address - Street 1:710 ROCK ROSE WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-1890
Practice Address - Country:US
Practice Address - Phone:773-350-7752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13634152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist