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Individual

DR. BETTY WAI-HAN LEE-VILLANUEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
330 N BRAND BLVD, SUITE 110, GLENDALE, CA 91203-2308
(866) 260-2020
Mailing address
330 N BRAND BLVD, SUITE 110, GLENDALE, CA 91203-2308
(866) 260-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11366T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041522
COLE PROVIDER NUMBER
CA
05
1306035118
CA
01
9362933
MEDICAL
CA
Enumeration date
06/22/2006
Last updated
12/16/2010
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