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General NPI Number Information
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NPI Number | 1932884731
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Entity Type | Organization
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Legal Business Name | WYSE WILLA OPTOMETRY, INC.
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 638 W DUARTE RD STE 10
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City | ARCADIA
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State | CA
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Zip | 91007-7619
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Country | US
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Telephone | 626-445-1186
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Fax | 626-445-1452
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Provider Business Mailing Address
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Address Line | 638 W DUARTE RD STE 10
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City | ARCADIA
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State | CA
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Zip | 91007-7619
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Country | US
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Telephone | 626-445-1186
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Fax | 626-445-1452
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Authorized Official
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Title or Position | CEO
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Name | DR. WENDY YVETTE MAY SHEM
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Credential | OD
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Telephone | 626-445-1186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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