Healthcare Provider Details

I. General information

NPI: 1518768985
Provider Name (Legal Business Name): CLAIRE C CHU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 W REDWOOD ST STE 470
BALTIMORE MD
21201-7009
US

IV. Provider business mailing address

419 W REDWOOD ST STE 470
BALTIMORE MD
21201-7009
US

V. Phone/Fax

Practice location:
  • Phone: 667-214-1232
  • Fax:
Mailing address:
  • Phone: 667-214-1232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA3171
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: