# LAURIE CHALKIN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WILD IRIS OPTOMETRIC GROUP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679641203
- **Authorized official:** MS. LAURIE RUTH CHAIKIN O.D. (OPTOMETRIST OWNER)
- **Authorized official phone:** (510) 538-3937

## Contact information

- **Practice address:** 3717 CASTRO VALLEY BLVD, CASTRO VALLEY, CA 94546-4405
- **Practice address phone:** (510) 538-3937
- **Mailing address:** 3717 CASTRO VALLEY BLVD, CASTRO VALLEY, CA 94546-4405
- **Mailing address phone:** (510) 538-3937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WL0500X | Low Vision Rehabilitation Optometrist | 10195 | CA | Yes |
| 152WV0400X | Vision Therapy Optometrist | 7597 | CA | — |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 07/22/2008