MEDICARE: DR. STEPHEN CHOY 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	7759T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C2459965	OTHER	CA	CORP ID #
2	227-5390-9	OTHER	CA	CORP STATE TAX ID #

General Provider Information

NPI Number	:	1962539692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN CHOY OD

Provider Business Mailing Address
First Line	:	1035 S DE ANZA BLVD
Second Line	:	SUITE ONE
City	:	SAN JOSE
State	:	CA
Zip	:	95129-2772
Country	:	US
Telephone Number	:	408-446-5533
Fax Number	:

Provider Business Practice Location Address
First Line	:	1035 S DE ANZA BLVD
Second Line	:	SUITE ONE
City	:	SAN JOSE
State	:	CA
Zip	:	95129-2772
Country	:	US
Telephone Number	:	408-446-5533
Fax Number	:

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/09/2007

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