Provider Demographics
NPI:1760507784
Name:DE ANZA VISION CENTER A PROFESSIONAL OPTOMETRIC CORPORATION
Entity Type:Organization
Organization Name:DE ANZA VISION CENTER A PROFESSIONAL OPTOMETRIC CORPORATION
Other - Org Name:STEPHEN CHOY, O.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-446-5533
Mailing Address - Street 1:1035 S DE ANZA BLVD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-2772
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1035 S DE ANZA BLVD
Practice Address - Street 2:SUITE ONE
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-2772
Practice Address - Country:US
Practice Address - Phone:408-446-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7759T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962539692OtherNPI TYPE 1 FOR INDIVIDUAL
CA1962539692OtherNPI TYPE 1 FOR INDIVIDUAL