Lee, Chan Woo

Lee, Chan Woo is an individual health care provider with primary practice located at 2790 Cabot Drive Suite 135, Corona CA 92883. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lee, Chan Woo can be contacted via phone (951) 277-2774.

Contact Information

Primary practice address
2790 Cabot Drive Suite 135 Corona CA 92883
Phone: (951) 277-2774
Fax: (951) 271-9754
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 12516TPA California

Profile Details

NPI number 1326038993
LBN Legal business name Lee, Chan Woo
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Feb 28th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326038993 NPPES
California MEDICAID 8073436

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