Laurie Chalkin

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

10195 Issued in CA

Legal business name

LAURIE CHALKIN

Doing business as

Wild Iris Optometric Group

Practice address

3717 Castro Valley Blvd
Castro Valley, CA 94546-4405

Phone

(510) 538-3937

NPI assigned

Dec 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Laurie Ruth Chaikin, O.D.

Title

Optometrist Owner

Phone

(510) 538-3937

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WILD IRIS OPTOMETRIC GROUP Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1679641203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 CASTRO VALLEY BLVD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464405",
            "telephone_number": "510-538-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 CASTRO VALLEY BLVD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464405",
            "telephone_number": "510-538-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURIE CHALKIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "CHAIKIN",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER",
        "authorized_official_telephone_number": "510-538-3937",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "10195",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "7597",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0101950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILD IRIS OPTOMETRIC GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gretchen Largusa, DPT
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• Laurel Grove Hospital-Rehab Unit
• Laurence Athos M D Inc
• Lavin Chiropractic
• Darrell Stephen Lavin, D.C.
• Lazaro Physical Therapy
• Eirely Elizabeth Lazenby
• Linh My Le, MT

• Low Vision Rehabilitation Optometrist in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Low Vision Rehabilitation Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.