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DR. JANET C CHAN OD
>> Optometrist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1356471205
Individual Registrant:DR. JANET C CHAN OD
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
500 ALFRED NOBEL DR STE 138 HERCULES, CA 94547-1838 US
Tel: 510-724-1000 Fax: --
Tel: 510-724-1000 Fax: --
Contact information for business:
500 ALFRED NOBEL DR STE 138 HERCULES, CA 94547-1838 US
Tel: 510-724-1000 Fax: --
Tel: 510-724-1000 Fax: --
Registration Information:
NPI: 1356471205
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 152W00000X | Eye and Vision Services Providers Optometrist | CA | 11107T |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| SDO111070 | CA | 05 |
