NPI Code Details Logo

NPI 1063897494

NPI 1063897494 : MANMEET CHATHA O.D. : CONCORD, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1063897494
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MANMEET CHATHA O.D.
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/27/2015
-----------------------------------------------------
    Last Update Date     |    03/20/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2415 HIGH SCHOOL AVE STE 200 
-----------------------------------------------------
    City                 |    CONCORD
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94520-1821
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    925-689-2852
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1950 OLD GALLOWS RD STE 520 
-----------------------------------------------------
    City                 |    VIENNA
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    22182-3970
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    703-847-8899
-----------------------------------------------------
    Fax                  |    571-223-6780
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    152W00000X
-----------------------------------------------------
    Taxonomy Name        |    Optometrist
-----------------------------------------------------
    License Number       |    046010938
-----------------------------------------------------
    License Number State |    IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    152W00000X
-----------------------------------------------------
    Taxonomy Name        |    Optometrist
-----------------------------------------------------
    License Number       |    0618002833
-----------------------------------------------------
    License Number State |    VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    152W00000X
-----------------------------------------------------
    Taxonomy Name        |    Optometrist
-----------------------------------------------------
    License Number       |    35100
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.