Healthcare Provider Details

I. General information

NPI: 1609005115
Provider Name (Legal Business Name): PEI-CHEN HSIEH O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6531 CROWN BLVD STE 4
SAN JOSE CA
95120-2906
US

IV. Provider business mailing address

6531 CROWN BLVD STE 4
SAN JOSE CA
95120-2906
US

V. Phone/Fax

Practice location:
  • Phone: 408-997-2020
  • Fax: 408-997-2072
Mailing address:
  • Phone: 949-502-1189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13738
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: