Healthcare Provider Details

I. General information

NPI: 1912597915
Provider Name (Legal Business Name): CHO & CHUN OPTOMETRY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 BRISTOL ST STE J
COSTA MESA CA
92626-3001
US

IV. Provider business mailing address

3033 BRISTOL ST STE J
COSTA MESA CA
92626-3001
US

V. Phone/Fax

Practice location:
  • Phone: 949-208-9090
  • Fax: 949-208-9090
Mailing address:
  • Phone: 949-208-9090
  • Fax: 949-208-9090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. HANNAH CHO
Title or Position: MANAGER
Credential: OD
Phone: 949-208-9090