Provider Demographics
NPI:1982701595
Name:CHIU, SARA Y (OD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:Y
Last Name:CHIU
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 1:1099 SIOUX CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-6542
Mailing Address - Country:US
Mailing Address - Phone:510-504-8588
Mailing Address - Fax:
Practice Address - Street 1:3100 CAPITOL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1527
Practice Address - Country:US
Practice Address - Phone:510-791-5272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13149152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist