Provider Demographics
NPI:1548484538
Name:CHEN, JULIE E (OD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:E
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:2030 MAIN ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-7219
Mailing Address - Country:US
Mailing Address - Phone:949-851-2015
Mailing Address - Fax:888-851-9029
Practice Address - Street 1:2272 MICHELSON DR STE 110
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1324
Practice Address - Country:US
Practice Address - Phone:949-545-8431
Practice Address - Fax:888-851-9029
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAOPT11113TLG152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT1113TLGOtherCALIFORNIA BOARD OF OPTOMETRY
CAFW403Medicare PIN