Active NPI
Eunmi Chae, O.D.
- Optometrist
- Van Nuys, CA
National Provider Identifier
1003029505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10123T
- Practice address
- 17631 Sherman Way
Van Nuys, CA 91406-3510 - Phone
- (818) 705-1001
- Fax
- (818) 609-0126
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 10123T | CA | Primary |
Addresses
Primary practice location
17631 Sherman Way
Van Nuys, CA 91406-3510
Mailing address
17631 Sherman Way
Van Nuys, CA 91406-3510
Phone (818) 705-1001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003029505 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10123T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540857600000",
"number": "1003029505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17631 SHERMAN WAY",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914063510",
"telephone_number": "818-705-1001",
"fax_number": "818-609-0126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17631 SHERMAN WAY",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914063510",
"telephone_number": "818-705-1001",
"fax_number": "818-609-0126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAE",
"first_name": "EUNMI",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2018-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10123T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003029505",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.