Provider Demographics
NPI:1386419786
Name:LISA E.S. VEAL, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:LISA E.S. VEAL, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:VEAL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:818-361-4020
Mailing Address - Street 1:15336 DEVONSHIRE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2763
Mailing Address - Country:US
Mailing Address - Phone:818-361-4020
Mailing Address - Fax:818-361-3966
Practice Address - Street 1:15336 DEVONSHIRE ST STE 4
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2763
Practice Address - Country:US
Practice Address - Phone:818-361-4020
Practice Address - Fax:818-361-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty