Provider Demographics
NPI:1770762445
Name:LESTER LEW OPTOMETRIST INC
Entity type:Organization
Organization Name:LESTER LEW OPTOMETRIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-282-4851
Mailing Address - Street 1:230 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3517
Mailing Address - Country:US
Mailing Address - Phone:626-282-4851
Mailing Address - Fax:626-576-4119
Practice Address - Street 1:230 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3517
Practice Address - Country:US
Practice Address - Phone:626-282-4851
Practice Address - Fax:626-576-4119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8270T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0082700Medicaid
CAWYO71Medicare PIN