MEDICARE: YABE OPTOMETRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	13038	CA

General Provider Information

NPI Number	:	1255579082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YABE OPTOMETRY

Provider Business Mailing Address
First Line	:	7843 KEW AVE
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91739-8801
Country	:	US
Telephone Number	:	909-646-8813
Fax Number	:	909-646-8636

Provider Business Practice Location Address
First Line	:	7843 KEW AVE
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91739-8801
Country	:	US
Telephone Number	:	909-646-8813
Fax Number	:	909-646-8636

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. LEANNE J LAU
Credential	:	O.D.
Telephone Number	:	909-646-8813

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	02/02/2009

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Directions to “YABE OPTOMETRY ” Practice Location

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