Provider Demographics
NPI:1285634386
Name:CHIN, WAIYEN (OD)
Entity type:Individual
Prefix:DR
First Name:WAIYEN
Middle Name:
Last Name:CHIN
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 1:625 PINEY FOREST RD
Mailing Address - Street 2:SUIT 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:SUIT 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
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001223152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1104939016OtherMEDICARE NPI
VA010148529Medicaid
VA010148529Medicaid
VAC09439Medicare UPIN