Organization
C K CHAN OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIU K CHAN O.D. (PRESIDENT)
(626) 854-0666
Entity
Organization
Contact information
Practice address
2707 E VALLEY BLVD, SUITE 101, WEST COVINA, CA 91792-3196
(626) 854-0666
(626) 854-1865
Mailing address
2707 E VALLEY BLVD., SUITE 101, WEST COVINA, CA 91792-3196
(626) 854-0666
(626) 854-1865
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT6179TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0061790
—
CA
05
—
SD0061791
—
CA
Enumeration date
01/08/2007
Last updated
05/22/2009
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