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General NPI Number Information
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NPI Number | 1942622931
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Entity Type | Organization
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Legal Business Name | CLEAR OPTOMETRY
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 138 E 3RD AVE
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City | SAN MATEO
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State | CA
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Zip | 94401-4013
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Country | US
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Telephone | 650-348-8818
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Fax | 650-348-8817
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Provider Business Mailing Address
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Address Line | 138 E 3RD AVE
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City | SAN MATEO
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State | CA
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Zip | 94401-4013
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Country | US
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Telephone | 650-348-8818
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Fax | 650-348-8817
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHERINE LOK CHAN
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Credential | O.D.
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Telephone | 650-348-8818
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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 | 11078
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License Number State | CA
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