Healthcare Provider Details

I. General information

NPI: 1255076436
Provider Name (Legal Business Name): COMMUNITY EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 LOGAN ST
DENVER CO
80216-1323
US

IV. Provider business mailing address

4985 MOORHEAD AVE UNIT 3718
BOULDER CO
80305-5522
US

V. Phone/Fax

Practice location:
  • Phone: 720-722-3377
  • Fax:
Mailing address:
  • Phone: 720-722-3377
  • Fax: 720-596-8856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MISS TING ZHANG
Title or Position: OPTOMETRIST
Credential: OD, FAAO
Phone: 720-722-3377