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NPI Code Detail

MEDICARE: DR. BRIAN CHOU O.D.

MEDICARE: DR. BRIAN CHOU O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist11119TCA

General Provider Information

NPI Number : 1013960996
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN CHOU O.D.
Provider Business Mailing Address
First Line : 2020 CAMINO DEL RIO N STE 109
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1542
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2020 CAMINO DEL RIO N STE 109
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1542
Country : US
Telephone Number : 619-299-6064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 05/11/2018

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