Provider Demographics
NPI:1104055631
Name:CHUM, NARY (OD)
Entity type:Individual
Prefix:DR
First Name:NARY
Middle Name:
Last Name:CHUM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3106
Mailing Address - Country:US
Mailing Address - Phone:650-596-1999
Mailing Address - Fax:650-596-1987
Practice Address - Street 1:750 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3106
Practice Address - Country:US
Practice Address - Phone:650-596-1999
Practice Address - Fax:650-596-1987
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13754152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist