Chung, Ida
Chung, Ida is an individual health care provider with primary practice located at 795 E Second Street Suite 2, Pomona CA 91766-2007. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Chung, Ida can be contacted via phone (909) 706-3899.Contact Information
Primary practice address
795 E Second Street Suite 2
Pomona CA 91766-2007
Phone: (909) 706-3899
Fax: (909) 469-8640
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT10241TPA | California |
Profile Details
| NPI number | 1346216280 |
|---|---|
| LBN Legal business name | Chung, Ida |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2006 |
| Last updated | Nov 2nd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346216280 | NPPES |
| California | Other | CB219775 | MEDICARE PTAN SO CAL |
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