Provider Demographics
NPI:1982696100
Name:LEE, SHARON WAI-MON (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:WAI-MON
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 TERESITA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1847
Mailing Address - Country:US
Mailing Address - Phone:415-387-8887
Mailing Address - Fax:
Practice Address - Street 1:1719 NORIEGA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4307
Practice Address - Country:US
Practice Address - Phone:415-351-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12404T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU98171Medicare UPIN
CASD0124040Medicare ID - Type Unspecified