Individual
DR. MAMIE CASSANDRA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5341 WYOMING BLVD NE STE D, ALBUQUERQUE, NM 87109-3164
(505) 821-8333
(505) 821-8335
Mailing address
5341 WYOMING BLVD NE, STE D, ALBUQUERQUE, NM 87109-3164
(505) 717-2005
(505) 312-7551
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
512
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A4896
—
NM
Enumeration date
08/18/2006
Last updated
05/25/2016
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