Healthcare Provider Details

I. General information

NPI: 1669515169
Provider Name (Legal Business Name): MAY-MAY CHAN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4241 CENTURY BLVD.
PITTSBURG CA
94565-7113
US

IV. Provider business mailing address

4241 CENTURY BLVD
PITTSBURG CA
94565-7113
US

V. Phone/Fax

Practice location:
  • Phone: 925-706-4400
  • Fax: 925-706-4411
Mailing address:
  • Phone: 925-706-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10298T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: