Provider Demographics
NPI:1255579082
Name:YABE OPTOMETRY
Entity type:Organization
Organization Name:YABE OPTOMETRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:909-646-8813
Mailing Address - Street 1:7843 KEW AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-8801
Mailing Address - Country:US
Mailing Address - Phone:909-646-8813
Mailing Address - Fax:909-646-8636
Practice Address - Street 1:7843 KEW AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-8801
Practice Address - Country:US
Practice Address - Phone:909-646-8813
Practice Address - Fax:909-646-8636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13038152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty