Provider Demographics
NPI:1104939016
Name:CENTRAL VISION, P.C.
Entity type:Organization
Organization Name:CENTRAL VISION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAIYEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:434-797-2606
Mailing Address - Street 1:625 PINEY FOREST RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-2867
Mailing Address - Country:US
Mailing Address - Phone:434-797-2606
Mailing Address - Fax:434-797-2606
Practice Address - Street 1:625 PINEY FOREST RD
Practice Address - Street 2:SUITE 208
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2867
Practice Address - Country:US
Practice Address - Phone:434-797-2606
Practice Address - Fax:434-797-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001223152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00W305C01Medicare UPIN
VAC09439Medicare ID - Type Unspecified