Individual
DR. EDWIN JEUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1094
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08010944
—
CO
01
—
1094
COLORADO LIC. #
CO
01
—
C40373
MEDICARE ID
CO
Enumeration date
10/26/2005
Last updated
06/21/2012
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