Provider Demographics
NPI:1508096314
Name:JAMISON, PEI LING CHOV (OD)
Entity Type:Individual
Prefix:DR
First Name:PEI LING
Middle Name:CHOV
Last Name:JAMISON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11316 GOODHUE ST NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4448
Mailing Address - Country:US
Mailing Address - Phone:612-206-6046
Mailing Address - Fax:
Practice Address - Street 1:7912 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-2218
Practice Address - Country:US
Practice Address - Phone:612-206-6046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3174152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist