Organization
LAURIE CHALKIN
Active
Other names
WILD IRIS OPTOMETRIC GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURIE RUTH CHAIKIN O.D. (OPTOMETRIST OWNER)
(510) 538-3937
Entity
Organization
Contact information
Practice address
3717 CASTRO VALLEY BLVD, CASTRO VALLEY, CA 94546-4405
(510) 538-3937
Mailing address
3717 CASTRO VALLEY BLVD, CASTRO VALLEY, CA 94546-4405
(510) 538-3937
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
10195
CA
152WV0400X
Vision Therapy Optometrist
7597
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0101950
—
CA
Enumeration date
12/01/2006
Last updated
07/22/2008
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