Provider Demographics
NPI:1629329875
Name:CHAN EYE CARE, PLLC
Entity Type:Organization
Organization Name:CHAN EYE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZOEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAN-PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-430-8800
Mailing Address - Street 1:1925 LANDSTOWN CENTRE WAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-1645
Mailing Address - Country:US
Mailing Address - Phone:757-430-8800
Mailing Address - Fax:757-430-8801
Practice Address - Street 1:1925 LANDSTOWN CENTRE WAY
Practice Address - Street 2:SUITE 250
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-1645
Practice Address - Country:US
Practice Address - Phone:757-430-8800
Practice Address - Fax:757-430-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001176152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1558405803Medicaid