Provider Demographics
NPI:1396275756
Name:LAVINDER, NATALIE CHUNG (OD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:CHUNG
Last Name:LAVINDER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:30212 TOMAS STE 170
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2174
Mailing Address - Country:US
Mailing Address - Phone:949-589-0900
Mailing Address - Fax:949-589-0767
Practice Address - Street 1:30212 TOMAS STE 170
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688
Practice Address - Country:US
Practice Address - Phone:949-589-0900
Practice Address - Fax:949-589-0767
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT33693-TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist