Basic Information
| Provider Information | |||||||||
| NPI: | 1851425110 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAN | ||||||||
| FirstName: | MAY | ||||||||
| MiddleName: | CHAU | ||||||||
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| Credential: | OPTOMETRY DOCTOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9684 CONEY ISLAND CIR | ||||||||
| Address2: | |||||||||
| City: | ELK GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957583650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164217915 | ||||||||
| FaxNumber: | 9164218396 | ||||||||
| Practice Location | |||||||||
| Address1: | 9684 CONEY ISLAND CIR | ||||||||
| Address2: | |||||||||
| City: | ELK GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957583650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164217915 | ||||||||
| FaxNumber: | 9164218396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 5642 | CA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.