Provider Demographics
NPI:1801371554
Name:CO, JOHNSON CHI AN (OD)
Entity type:Individual
Prefix:DR
First Name:JOHNSON
Middle Name:CHI AN
Last Name:CO
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:5800 W ARIZONA PAVILIONS DR UNIT 1392
Mailing Address - Street 2:
Mailing Address - City:CORTARO
Mailing Address - State:AZ
Mailing Address - Zip Code:85652-2955
Mailing Address - Country:US
Mailing Address - Phone:714-791-8016
Mailing Address - Fax:
Practice Address - Street 1:7396 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2305
Practice Address - Country:US
Practice Address - Phone:520-229-1554
Practice Address - Fax:520-229-1702
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2025-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZOPT-002308152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist