Provider Demographics
NPI:1902244973
Name:CAIN, CHELSEA (OD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:CAIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:CAIN
Other - Last Name:TURK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2662 E VERMONT CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2321
Mailing Address - Country:US
Mailing Address - Phone:480-828-3480
Mailing Address - Fax:
Practice Address - Street 1:14780 W. MOUNTAIN VIEW BLVD.
Practice Address - Street 2:SUITE 110
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7280
Practice Address - Country:US
Practice Address - Phone:623-374-7774
Practice Address - Fax:877-796-5302
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1982152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program