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General NPI Number Information
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NPI Number | 1134496847
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Entity Type | Organization
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Legal Business Name | BEACH FAMILY EYECARE PC
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 4200 PORTSMOUTH BLVD STE 49
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2100
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Country | US
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Telephone | 757-465-8788
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 PORTSMOUTH BLVD STE 49
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. CHIMING CHEUNG
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Credential | OD
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Telephone | 757-465-8788
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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 | 0618002007
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License Number State | VA
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