Provider Demographics
NPI:1154481216
Name:CHAR, GREGORY G (OD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:G
Last Name:CHAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:850 E CHAPMAN AVE
Mailing Address - Street 2:STE B
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1649
Mailing Address - Country:US
Mailing Address - Phone:714-538-1434
Mailing Address - Fax:714-639-2530
Practice Address - Street 1:850 E CHAPMAN AVE
Practice Address - Street 2:STE B
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1649
Practice Address - Country:US
Practice Address - Phone:714-538-1434
Practice Address - Fax:714-639-2530
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA7901T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0979150001Medicare NSC
CAFO404AMedicare PIN