Provider Demographics
NPI:1487646931
Name:DUHN, CHANNIE A (OD)
Entity Type:Individual
Prefix:DR
First Name:CHANNIE
Middle Name:A
Last Name:DUHN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:158 THROCKMORTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1919
Mailing Address - Country:US
Mailing Address - Phone:415-388-8262
Mailing Address - Fax:415-388-2234
Practice Address - Street 1:158 THROCKMORTON AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1919
Practice Address - Country:US
Practice Address - Phone:415-388-8262
Practice Address - Fax:415-388-2234
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA9935T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA47357Medicare UPIN