Provider Demographics
NPI:1386701050
Name:SEA, WEN-CHING W (OD)
Entity type:Individual
Prefix:
First Name:WEN-CHING
Middle Name:W
Last Name:SEA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:WINNIE
Other - Middle Name:
Other - Last Name:SEA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2295 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1172
Mailing Address - Country:US
Mailing Address - Phone:714-227-5826
Mailing Address - Fax:
Practice Address - Street 1:101 NEWPORT CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6905
Practice Address - Country:US
Practice Address - Phone:714-892-6608
Practice Address - Fax:714-892-2256
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 12752152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist