Healthcare Provider Details

I. General information

NPI: 1679920060
Provider Name (Legal Business Name): ASHLEY CHIANG TJOE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY CHIANG O.D.

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 YGNACIO VALLEY RD SUITE A
WALNUT CREEK CA
94598-3587
US

IV. Provider business mailing address

2801 YGNACIO VALLEY RD SUITE A
WALNUT CREEK CA
94598-3587
US

V. Phone/Fax

Practice location:
  • Phone: 925-933-2600
  • Fax:
Mailing address:
  • Phone: 626-272-1855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number33369
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: