MEDICARE: MRS. ELAINA I-LING CHIAO O.D.

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	11866T	CA

General Provider Information

NPI Number	:	1518081447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELAINA I-LING CHIAO O.D.

Provider Business Mailing Address
First Line	:	5100 E ANAHEIM RD STE B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-4215
Country	:	US
Telephone Number	:	714-926-0405
Fax Number	:

Provider Business Practice Location Address
First Line	:	5219 E 2ND ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5316
Country	:	US
Telephone Number	:	562-438-1211
Fax Number	:

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

Provider Enumeration Date	:	03/17/2007
Last Update Date	:	07/08/2007

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