Provider Demographics
NPI:1609889260
Name:CHIU, DAVID N (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:CHIU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 SPALDING ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-6694
Mailing Address - Country:US
Mailing Address - Phone:510-589-9213
Mailing Address - Fax:
Practice Address - Street 1:554 SPALDING ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-6694
Practice Address - Country:US
Practice Address - Phone:510-589-9213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12282T152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD 0122820Medicare PIN