Provider Demographics
NPI:1558052951
Name:CHAU, VIVIAN (OD)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:CHAU
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 1:1535 OWENS CT
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1182
Mailing Address - Country:US
Mailing Address - Phone:626-757-3129
Mailing Address - Fax:
Practice Address - Street 1:1535 OWENS CT
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1182
Practice Address - Country:US
Practice Address - Phone:626-757-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35427152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist