Dr. Lisa Chung Yun Mak, OD
Optometrist in San Gabriel, CA. Individual provider (NPI-1).
NPI number1649944331
StatusActive
Last updated in NPPESDec 22, 2021
Details
- NPI
- 1649944331
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lisa Chung Yun Mak
- Credential
- OD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 5, 2021
- Certification date
- Dec 22, 2021
- Last updated
- Dec 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 34840 | CA | Yes |
Other names
- Lisa Chung Yun Chan (Former Name)
Practice location
251 W Bencamp StSan Gabriel, CA 91776-3798
Phone 626-282-2567
Mailing address
124 FixieIrvine, CA 92618-1033
Phone 949-290-2739
Other practice locations
6440 E Pacific Coast Hwy Spc B-165
Long Beach, CA 90803-4268
Long Beach, CA 90803-4268
Phone 562-280-2148
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