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TRACY CHAN

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1992114565

Individual Registrant:
 TRACY  CHAN 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
476 SAN MATEO AVE  SAN BRUNO, CA 94066-4437 US
Tel: 650-589-4130  Fax: --

Contact information for business:
23 BUCKINGHAM DR  MORAGA, CA 94556-2406 US
Tel: 925-878-9359  Fax: --

Registration Information:
NPI: 1992114565
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
CA15083

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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