Provider Demographics
NPI:1386766723
Name:LEE, SU HUEI (DO)
Entity type:Individual
Prefix:MS
First Name:SU
Middle Name:HUEI
Last Name:LEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2447 W VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-1933
Mailing Address - Country:US
Mailing Address - Phone:626-300-9251
Mailing Address - Fax:626-300-8911
Practice Address - Street 1:2447 W VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-1933
Practice Address - Country:US
Practice Address - Phone:626-300-9251
Practice Address - Fax:626-300-8911
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACL942 AND SL994156FX1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1202XEye and Vision Services ProvidersTechnician/TechnologistOptometric Technician