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General NPI Number Information
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NPI Number | 1023481496
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Entity Type | Organization
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Legal Business Name | EYECHECK OPTOMETRY INC
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Dates
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Enumeration Date | 11/08/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 7743 WEST LN SUITE A2
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City | STOCKTON
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State | CA
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Zip | 95210-3348
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Country | US
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Telephone | 209-636-4914
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Fax | 209-208-1819
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Provider Business Mailing Address
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Address Line | 7743 WEST LN SUITE A-2
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City | STOCKTON
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State | CA
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Zip | 95210-3348
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Country | US
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Telephone | 209-636-4914
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Fax | 209-208-1819
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. CHUKWUEMEKA CHIKWENDU
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Credential | O.D.
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Telephone | 209-817-5654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT 13449 T
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License Number State | CA
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