Provider Demographics
NPI:1962539692
Name:CHOY, STEPHEN (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:CHOY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 S DE ANZA BLVD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-2772
Mailing Address - Country:US
Mailing Address - Phone:408-446-5533
Mailing Address - Fax:
Practice Address - Street 1:1035 S DE ANZA BLVD
Practice Address - Street 2:SUITE ONE
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-2772
Practice Address - Country:US
Practice Address - Phone:408-446-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7759T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC2459965OtherCORP ID #
CA227-5390-9OtherCORP STATE TAX ID #
CAC2459965OtherCORP ID #
CA227-5390-9OtherCORP STATE TAX ID #