Healthcare Provider Details

I. General information

NPI: 1982141206
Provider Name (Legal Business Name): MEI LEE FLEMING OPTOMETRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3444 MT DIABLO BLVD
LAFAYETTE CA
94549-3912
US

IV. Provider business mailing address

5 MORAGA VALLEY LN
MORAGA CA
94556-1156
US

V. Phone/Fax

Practice location:
  • Phone: 415-601-6568
  • Fax:
Mailing address:
  • Phone: 415-601-6568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number11635T
License Number StateCA

VIII. Authorized Official

Name: DR. MEI LEE FLEMING
Title or Position: CEO
Credential: O.D.
Phone: 415-601-6568