MEDICARE: DR. MARY ANN CHEN SHUI OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT11806-TLG	CA

General Provider Information

NPI Number	:	1386729713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ANN CHEN SHUI OD

Provider Business Mailing Address
First Line	:	45584 CHEROKEE LN
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94539-6820
Country	:	US
Telephone Number	:	408-278-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 S WINCHESTER BLVD STE E156
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-3903
Country	:	US
Telephone Number	:	408-244-8700
Fax Number	:	408-244-9560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	03/12/2018

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