Provider Demographics
NPI:1952495764
Name:CHANNIE DUHN OD A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:CHANNIE DUHN OD A PROFESSIONAL CORP
Other - Org Name:MARIN OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUHN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:415-388-8262
Mailing Address - Street 1:158 THROCKMORTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1919
Mailing Address - Country:US
Mailing Address - Phone:415-388-8262
Mailing Address - Fax:415-388-2234
Practice Address - Street 1:158 THROCKMORTON AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1919
Practice Address - Country:US
Practice Address - Phone:415-388-8262
Practice Address - Fax:415-388-2234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9935T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty