Provider Demographics
NPI:1902974017
Name:TONY CHAHINE, O.D., INC., APC
Entity Type:Organization
Organization Name:TONY CHAHINE, O.D., INC., APC
Other - Org Name:LA CANADA EYE CARE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAHINE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:818-790-0422
Mailing Address - Street 1:1419 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2108
Mailing Address - Country:US
Mailing Address - Phone:818-790-0422
Mailing Address - Fax:818-790-0484
Practice Address - Street 1:1419 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-2108
Practice Address - Country:US
Practice Address - Phone:818-790-0422
Practice Address - Fax:818-790-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10577T152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU58226Medicare UPIN
CADM869AMedicare PIN
CA5003100001Medicare NSC