Provider Demographics
NPI:1922144625
Name:CHAN, RICHARD SHING (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SHING
Last Name:CHAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1635 DIVISADERO ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3036
Mailing Address - Country:US
Mailing Address - Phone:415-833-3971
Mailing Address - Fax:415-833-2790
Practice Address - Street 1:1635 DIVISADERO ST
Practice Address - Street 2:SUITE 360
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3036
Practice Address - Country:US
Practice Address - Phone:415-833-3971
Practice Address - Fax:415-833-2790
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8944152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist