Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 10514T | CA |
NPI | 1003888728 |
---|---|
Provider Name | Dr. Janis Lei Mayeda |
First Address | Torrance, CA 90504 |
Second Address | Torrance, CA 90504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 08/07/2007 |