Healthcare Provider Details

I. General information

NPI: 1548815194
Provider Name (Legal Business Name): FERNANDO CHEN, O.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2019
Last Update Date: 10/23/2022
Certification Date: 10/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 CLOVIS AVE
CLOVIS CA
93612-3915
US

IV. Provider business mailing address

1445 R ST
MERCED CA
95340-5850
US

V. Phone/Fax

Practice location:
  • Phone: 559-712-7878
  • Fax: 559-203-3886
Mailing address:
  • Phone: 209-726-8116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. FERNANDO CHEN
Title or Position: OWNER
Credential: OD
Phone: 714-686-0439