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General NPI Number Information
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NPI Number | 1538497540
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Entity Type | Organization
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Legal Business Name | BRENT P. CHINN, OD AND DAVID M. REDMAN, OD, OPTOMETRIC GROUP, INC
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Dates
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Enumeration Date | 12/02/2009
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 1039 EL MONTE AVE STE K
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2371
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Country | US
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Telephone | 650-967-0140
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Fax | 650-967-3925
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Provider Business Mailing Address
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Address Line | 1039 EL MONTE AVE STE K
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2371
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Country | US
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Telephone | 650-967-0140
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Fax | 650-967-3925
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Authorized Official
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Title or Position | OWNER
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Name | BRENT PHILLIP CHINN
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Credential | O.D.
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Telephone | 650-967-0140
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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 | 9874T
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License Number State | CA
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