Provider Demographics
NPI:1053365254
Name:LECH, AARON EDWARD (OD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:EDWARD
Last Name:LECH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N SUNRISE AVE
Mailing Address - Street 2:STE C-2
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2916
Mailing Address - Country:US
Mailing Address - Phone:916-786-2212
Mailing Address - Fax:916-786-2393
Practice Address - Street 1:114 N SUNRISE AVE
Practice Address - Street 2:STE C-2
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2916
Practice Address - Country:US
Practice Address - Phone:916-786-2212
Practice Address - Fax:916-786-2393
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11839T152W00000X
OR2833T152W00000X
CA11839 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6059480001Medicare NSC
CAU98364Medicare UPIN
SD118390Medicare PIN