Healthcare Provider Details

I. General information

NPI: 1578558706
Provider Name (Legal Business Name): MEI LEE FLEMING OD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 DANVILLE BLVD SUITE 165
ALAMO CA
94507-1938
US

IV. Provider business mailing address

5 MORAGA VALLEY LN
MORAGA CA
94556-1156
US

V. Phone/Fax

Practice location:
  • Phone: 925-820-6622
  • Fax: 925-820-5226
Mailing address:
  • Phone: 925-330-1512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11635T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: