Provider Demographics
NPI:1932324670
Name:AHN, WENDY NI (OD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:NI
Last Name:AHN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:NI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:26 DEL MONTE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022
Mailing Address - Country:US
Mailing Address - Phone:650-947-0671
Mailing Address - Fax:
Practice Address - Street 1:261 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-2909
Practice Address - Country:US
Practice Address - Phone:650-947-3937
Practice Address - Fax:650-947-3935
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12738T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist