MEDICARE: DR. STEPHEN KEITH CHING 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	9223T	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4481310002	OTHER	CA	CIGNA MEDICARE
2	4481310001	OTHER	CA	CIGNA MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760478028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN KEITH CHING O.D.

Provider Business Mailing Address
First Line	:	103 TOWER ROCK CT
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-7153
Country	:	US
Telephone Number	:	916-987-9661
Fax Number	:

Provider Business Practice Location Address
First Line	:	2248 SUNRISE BLVD
Second Line	:
City	:	GOLD RIVER
State	:	CA
Zip	:	95670-4342
Country	:	US
Telephone Number	:	916-638-3878
Fax Number	:

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. STEPHEN KEITH CHING O.D.” Practice Location

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