Wong, Dianne Lee

Wong, Dianne Lee is an individual health care provider with primary practice located at 901 E St Ste 285, San Rafael CA 94901-2850. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Wong, Dianne Lee can be contacted via phone (415) 454-5565.

Contact Information

Primary practice address
901 E St Ste 285 San Rafael CA 94901-2850
Phone: (415) 454-5565
Fax: (415) 454-2957
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 11780 California

Profile Details

NPI number 1750384061
LBN Legal business name Wong, Dianne Lee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Jan 3rd, 2022 - about 2 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 1750384061 NPPES
California MEDICAID GR0015750

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