Provider Demographics
NPI:1699885830
Name:YEUNG LANDERVILLE, KAREEN (OD)
Entity type:Individual
Prefix:DR
First Name:KAREEN
Middle Name:
Last Name:YEUNG LANDERVILLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7455 W WASHINGTON AVE STE 470
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4338
Mailing Address - Country:US
Mailing Address - Phone:702-998-8798
Mailing Address - Fax:702-998-4181
Practice Address - Street 1:7455 W WASHINGTON AVE STE 470
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4338
Practice Address - Country:US
Practice Address - Phone:702-998-8798
Practice Address - Fax:702-998-4181
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4589152W00000X
CA11987T152WV0400X
NV756152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP11987AMedicare ID - Type Unspecified
000327202Medicare PIN
CAU91446Medicare UPIN