Provider Demographics
NPI:1255597266
Name:CHU, MARLENA AKIKO (OD)
Entity type:Individual
Prefix:DR
First Name:MARLENA
Middle Name:AKIKO
Last Name:CHU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:U.C. BERKELEY SCHOOL OF OPTOMETRY
Mailing Address - Street 2:200 MINOR HALL
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94720-2020
Mailing Address - Country:US
Mailing Address - Phone:510-642-2020
Mailing Address - Fax:510-642-8012
Practice Address - Street 1:U.C. BERKELEY SCHOOL OF OPTOMETRY
Practice Address - Street 2:200 MINOR HALL
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94720-2020
Practice Address - Country:US
Practice Address - Phone:510-642-2020
Practice Address - Fax:510-642-8012
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13584T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist