Basic Information
| Provider Information | |||||||||
| NPI: | 1669995916 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LE | ||||||||
| FirstName: | HELEN | ||||||||
| MiddleName: | WANG | ||||||||
| NamePrefix: | DR. | ||||||||
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| OtherLastName: | WANG | ||||||||
| OtherFirstName: | HELEN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5519 SARA MAR LN | ||||||||
| Address2: | |||||||||
| City: | TEMPLE CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917802528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582291767 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11525 BROOKSHIRE AVE STE 201A | ||||||||
| Address2: | |||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902414985 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008982020 | ||||||||
| FaxNumber: | 8448973788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2017 | ||||||||
| LastUpdateDate: | 08/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 33767TLG | CA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.