Provider Demographics
NPI:1881889418
Name:DR EUNMI CHAE OPTOMETRY INC
Entity type:Organization
Organization Name:DR EUNMI CHAE OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUNMI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:213-268-9915
Mailing Address - Street 1:17631 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3510
Mailing Address - Country:US
Mailing Address - Phone:213-268-9915
Mailing Address - Fax:
Practice Address - Street 1:17631 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3510
Practice Address - Country:US
Practice Address - Phone:818-705-1001
Practice Address - Fax:818-609-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10123T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1003029505OtherINDIVIDUAL NPI NUMBER