Jeung, Edwin
Jeung, Edwin is an sole proprietor health care provider with primary practice located at 1044 S 88Th St Ste 109 , Louisville CO 80027-9418. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jeung, Edwin can be contacted via phone (303) 666-0104.Contact Information
Primary practice address
1044 S 88Th St Ste 109
Louisville CO 80027-9418
Phone: (303) 666-0104
Fax: (303) 666-6844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1094 | Colorado |
Profile Details
| NPI number | 1033109483 |
|---|---|
| LBN Legal business name | Jeung, Edwin |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Jun 21st, 2012 - about 13 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 | 1033109483 | NPPES |
| Colorado | MEDICAID | 08010944 | |
| Colorado | Other | 1094 | |
| Colorado | Other | C40373 |
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