Healthcare Provider Details

I. General information

NPI: 1639537251
Provider Name (Legal Business Name): WENDY SHEM YEH, OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2016
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1368 E WALNUT ST
PASADENA CA
91106-1528
US

IV. Provider business mailing address

1368 E WALNUT ST
PASADENA CA
91106-1528
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-3105
  • Fax: 626-796-8816
Mailing address:
  • Phone: 626-796-3105
  • Fax: 626-796-8816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10731
License Number StateCA

VIII. Authorized Official

Name: DR. WENDY YVETTE SHEM YEH
Title or Position: OPTOMETRIST
Credential: OD
Phone: 626-796-3105