Provider Demographics
NPI:1295929818
Name:CHEN, ELIZABETH LEE (OD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LEE
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:OK-SOON
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3451 W CENTURY BLVD
Mailing Address - Street 2:SUITE B-3
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90303-1227
Mailing Address - Country:US
Mailing Address - Phone:310-419-3365
Mailing Address - Fax:
Practice Address - Street 1:3451 W CENTURY BLVD
Practice Address - Street 2:SUITE B-3
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-1227
Practice Address - Country:US
Practice Address - Phone:310-419-3365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13399152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist