Provider Demographics
NPI:1750554002
Name:JEONG, CHU YONG (OD)
Entity type:Individual
Prefix:
First Name:CHU
Middle Name:YONG
Last Name:JEONG
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 1:5001 S. PARKER RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015
Mailing Address - Country:US
Mailing Address - Phone:720-507-7004
Mailing Address - Fax:720-507-7009
Practice Address - Street 1:5001 S PARKER RD STE 204
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1183
Practice Address - Country:US
Practice Address - Phone:720-507-7004
Practice Address - Fax:720-570-7009
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5481152W00000X
CO2249152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist