Provider Demographics
NPI:1215770656
Name:CHAU, CINDY
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:CHAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4541 LIVIA AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1438
Mailing Address - Country:US
Mailing Address - Phone:626-560-4292
Mailing Address - Fax:
Practice Address - Street 1:450 N BEDFORD DR STE 101
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4305
Practice Address - Country:US
Practice Address - Phone:310-274-9205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT35689-TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist