Healthcare Provider Details

I. General information

NPI: 1578599197
Provider Name (Legal Business Name): LAWRENCE CHI CHAO MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALTON PKWY STE 102
IRVINE CA
92606-5032
US

IV. Provider business mailing address

2500 ALTON PKWY STE 102
IRVINE CA
92606-5032
US

V. Phone/Fax

Practice location:
  • Phone: 949-679-2426
  • Fax: 949-679-2616
Mailing address:
  • Phone: 949-679-2426
  • Fax: 949-679-2616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG84067
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNE QUYNH-GIAO N TRAN
Title or Position: ADMINISTRATOR
Credential: PHARMD
Phone: 949-679-2426