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General NPI Number Information
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NPI Number | 1649465774
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Entity Type | Individual
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Provider Name | YOUNG SUN CHAO O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 3060 E 9TH ST #B
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City | OAKLAND
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State | CA
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Zip | 94601-2905
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Country | US
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Telephone | 510-535-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 5455 SHATTUCK AVE
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City | FREMONT
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State | CA
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Zip | 94555-2973
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Country | US
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Telephone | 415-671-9617
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 13325
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License Number State | CA
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