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NPI Code Detail

MEDICARE: WYSE WILLA OPTOMETRY, INC.

MEDICARE: WYSE WILLA OPTOMETRY, INC.
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
1152WC0802XCorneal and Contact Management Optometrist
2152WP0200XPediatric Optometrist
3152WS0006XSports Vision Optometrist
4152WV0400XVision Therapy Optometrist
5152W00000XOptometrist

General Provider Information

NPI Number : 1770203283
Entity Type Code : Organization
Provider Name (Legal Business Name) : WYSE WILLA OPTOMETRY, INC.
Provider Business Mailing Address
First Line : 1368 E WALNUT ST
Second Line :
City : PASADENA
State : CA
Zip : 91106-1528
Country : US
Telephone Number : 626-796-3105
Fax Number : 626-796-8816
Provider Business Practice Location Address
First Line : 1368 E WALNUT ST
Second Line :
City : PASADENA
State : CA
Zip : 91106-1528
Country : US
Telephone Number : 626-796-3105
Fax Number : 626-796-8816
Authorized Official
Title or Position : OWNER
Name : DR. WENDY SHEM YEH
Credential : OD
Telephone Number : 626-796-3105
Provider Enumeration Date : 09/02/2022
Last Update Date : 09/02/2022

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Directions to “WYSE WILLA OPTOMETRY, INC. ” Practice Location

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