Provider Demographics
NPI:1245816040
Name:OEI, AUDREY LEE
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:LEE
Last Name:OEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S. MAIN ST.
Mailing Address - Street 2:SUITE 525
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-456-5631
Mailing Address - Fax:714-285-0389
Practice Address - Street 1:505 S. MAIN ST.
Practice Address - Street 2:SUITE 525
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-456-5631
Practice Address - Fax:714-285-0389
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program