Provider Demographics
NPI:1235850355
Name:WANG, KAI UEN KATY (OD)
Entity type:Individual
Prefix:DR
First Name:KAI UEN
Middle Name:KATY
Last Name:WANG
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 W COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-1302
Mailing Address - Country:US
Mailing Address - Phone:626-293-7556
Mailing Address - Fax:
Practice Address - Street 1:2207 W COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-1302
Practice Address - Country:US
Practice Address - Phone:626-293-7556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35281152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist