Healthcare Provider Details

I. General information

NPI: 1881779098
Provider Name (Legal Business Name): CHINO FAMILY OPTOMETRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13788 ROSWELL AVE #106
CHINO CA
91710-1400
US

IV. Provider business mailing address

13788 ROSWELL AVE #106
CHINO CA
91710-1400
US

V. Phone/Fax

Practice location:
  • Phone: 626-353-4521
  • Fax:
Mailing address:
  • Phone: 626-353-4521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT11120TPA
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPT 11120TPA
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberOPT 11120TPA
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberOPT 11120TPA
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License NumberOPT 11120TPA
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberOPT 11120TPA
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License NumberOPT 11120TPA
License Number StateCA

VIII. Authorized Official

Name: DR. REX L.C. CHU
Title or Position: PRESIDENT CEO
Credential: OD
Phone: 626-353-4521