Provider Demographics
NPI:1821057951
Name:CHEW, DEBORAH D (OD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:CHEW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:D
Other - Last Name:LEONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:39355 CALIFORNIA ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1447
Mailing Address - Country:US
Mailing Address - Phone:510-744-2010
Mailing Address - Fax:510-744-2015
Practice Address - Street 1:39355 CALIFORNIA ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1447
Practice Address - Country:US
Practice Address - Phone:510-744-2010
Practice Address - Fax:510-744-2015
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6413T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0064130Medicare PIN
T10315Medicare UPIN
T10315Medicare UPIN
CAGR0022890Medicaid