Healthcare Provider Details

I. General information

NPI: 1528821956
Provider Name (Legal Business Name): FENIX LUMI, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3951 GRAND AVE
CHINO CA
91710-5429
US

IV. Provider business mailing address

4880 GLENVIEW ST
CHINO HILLS CA
91709-7413
US

V. Phone/Fax

Practice location:
  • Phone: 909-438-1185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: LYNSIE L CHU
Title or Position: PRESIDENT
Credential: OD
Phone: 909-438-1185