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General NPI Number Information
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NPI Number | 1902244973
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Entity Type | Individual
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Provider Name | CHELSEA CAIN O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 14780 W. MOUNTAIN VIEW BLVD. SUITE 110
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City | SURPRISE
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State | AZ
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Zip | 85374-7280
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Country | US
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Telephone | 623-374-7774
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Fax | 877-796-5302
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Provider Business Mailing Address
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Address Line | 2662 E VERMONT CT
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City | GILBERT
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State | AZ
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Zip | 85295-2321
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Country | US
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Telephone | 480-828-3480
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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 | 1982
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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