Provider Demographics
NPI:1770203283
Name:WYSE WILLA OPTOMETRY, INC.
Entity type:Organization
Organization Name:WYSE WILLA OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEM YEH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-796-3105
Mailing Address - Street 1:1368 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1528
Mailing Address - Country:US
Mailing Address - Phone:626-796-3105
Mailing Address - Fax:626-796-8816
Practice Address - Street 1:1368 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1528
Practice Address - Country:US
Practice Address - Phone:626-796-3105
Practice Address - Fax:626-796-8816
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WYSE WILLA OPTOMETRY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty