Healthcare Provider Details

I. General information

NPI: 1891998241
Provider Name (Legal Business Name): EICHIN CHANG-LIM O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14905 PARAMOUNT BLVD UNIT E
PARAMOUNT CA
90723-3440
US

IV. Provider business mailing address

14905 PARAMOUNT BLVD UNIT E
PARAMOUNT CA
90723-3440
US

V. Phone/Fax

Practice location:
  • Phone: 562-633-6046
  • Fax:
Mailing address:
  • Phone: 562-633-6046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberCA8688T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: