Individual
DR. EDWIN JEUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1044 S 88TH ST STE 109, LOUISVILLE, CO 80027-9418
(303) 666-0104
(303) 666-6844
Mailing address
1044 S 88TH ST STE 109, LOUISVILLE, CO 80027-9418
(303) 666-0104
(303) 666-6844
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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