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NPI Code Detail

MEDICARE: CHOON SHAN LOO OD

MEDICARE: CHOON SHAN LOO 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
1152W00000XOptometristOPT-002950AZ

General Provider Information

NPI Number : 1528906674
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHOON SHAN LOO OD
Provider Business Mailing Address
First Line : 955 W SOUTHERN AVE STE 101
Second Line :
City : MESA
State : AZ
Zip : 85210-4903
Country : US
Telephone Number : 480-961-1702
Fax Number :
Provider Business Practice Location Address
First Line : 3601 S 6TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85723-0001
Country : US
Telephone Number : 520-792-1450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 06/17/2026

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Directions to “ CHOON SHAN LOO OD” Practice Location

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