Provider Demographics
NPI:1760687396
Name:OO, KHIN SWE (OD)
Entity Type:Individual
Prefix:DR
First Name:KHIN
Middle Name:SWE
Last Name:OO
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 1:3158 WINDMILL DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3672
Mailing Address - Country:US
Mailing Address - Phone:714-685-9179
Mailing Address - Fax:
Practice Address - Street 1:22633 SAVI RANCH PKWY
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-4647
Practice Address - Country:US
Practice Address - Phone:714-685-9179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11088T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist