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General NPI Number Information
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NPI Number | 1770005183
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Entity Type | Individual
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Provider Name | AUDREY CHU OD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 07/07/2017
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Provider Practice Location Address
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Address Line | 286 STATE ST
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City | LOS ALTOS
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State | CA
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Zip | 94022-2813
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Country | US
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Telephone | 650-948-6910
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Fax |
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Provider Business Mailing Address
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Address Line | 1219 THURSTON AVE
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City | LOS ALTOS
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State | CA
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Zip | 94024-6865
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Country | US
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Telephone | 16508233588
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 33720
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License Number State | CA
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