Provider Demographics
NPI:1194862250
Name:CHEN, RUTH J (OD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:J
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:RUTH
Other - Middle Name:CHEN
Other - Last Name:FRUIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1051 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706
Mailing Address - Country:US
Mailing Address - Phone:510-526-3937
Mailing Address - Fax:510-526-6133
Practice Address - Street 1:1051 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706
Practice Address - Country:US
Practice Address - Phone:510-526-3937
Practice Address - Fax:510-526-6133
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11114TPG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0111140Medicare PIN
CAU77189Medicare UPIN