Provider Demographics
NPI:1720278575
Name:CHEN, YAU-RU (OD)
Entity Type:Individual
Prefix:DR
First Name:YAU-RU
Middle Name:
Last Name:CHEN
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 1:13408 HERITAGE WAY
Mailing Address - Street 2:APT 132
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-9101
Mailing Address - Country:US
Mailing Address - Phone:847-271-0835
Mailing Address - Fax:610-271-0832
Practice Address - Street 1:3417 VIA LIDO
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3908
Practice Address - Country:US
Practice Address - Phone:949-673-1883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13316152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist