MEDICARE: DR. KAREEN YEUNG LANDERVILLE O.D.

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	4589	MA
2	152WV0400X	Vision Therapy Optometrist	11987T	CA
3	152W00000X	Optometrist	756	NV

General Provider Information

NPI Number	:	1699885830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREEN YEUNG LANDERVILLE O.D.

Provider Business Mailing Address
First Line	:	7455 W WASHINGTON AVE STE 470
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-4338
Country	:	US
Telephone Number	:	702-998-8798
Fax Number	:	702-998-4181

Provider Business Practice Location Address
First Line	:	7455 W WASHINGTON AVE STE 470
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-4338
Country	:	US
Telephone Number	:	702-998-8798
Fax Number	:	702-998-4181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/21/2021

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