Provider Demographics
NPI:1730558784
Name:C & C OPTOMETRY, INC.
Entity type:Organization
Organization Name:C & C OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/O.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-997-7500
Mailing Address - Street 1:311 N TUSTIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-7776
Mailing Address - Country:US
Mailing Address - Phone:714-997-7500
Mailing Address - Fax:714-997-4864
Practice Address - Street 1:311 N TUSTIN ST STE B
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-7776
Practice Address - Country:US
Practice Address - Phone:714-997-7500
Practice Address - Fax:714-997-4864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 12280 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty