MEDICARE: CLEAR CONCEPTS OPTOMETRY, INC

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	14690	CA

General Provider Information

NPI Number	:	1417347188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR CONCEPTS OPTOMETRY, INC

Provider Business Mailing Address
First Line	:	1575 ALUM ROCK AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-2426
Country	:	US
Telephone Number	:	408-259-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1575 ALUM ROCK AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-2426
Country	:	US
Telephone Number	:	408-259-2020
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	DR. GLORIA CHOW
Credential	:	OD
Telephone Number	:	408-259-2020

Provider Enumeration Date	:	02/02/2015
Last Update Date	:	02/02/2015

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