Provider Demographics
NPI:1518417245
Name:GEORGE CHOUEIRY, O.D., OPTOMETRIC CORP.
Entity Type:Organization
Organization Name:GEORGE CHOUEIRY, O.D., OPTOMETRIC CORP.
Other - Org Name:LAGUNA NIGUEL OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUEIRY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-632-7801
Mailing Address - Street 1:30001 CROWN VALLEY PKWY STE F
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30001 CROWN VALLEY PKWY STE F
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1723
Practice Address - Country:US
Practice Address - Phone:949-495-1610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty