Organization Active NPI

Rainbow Optometry,Inc.

  • Optometrist
  • Upland, CA
National Provider Identifier
1043416860
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10945T Issued in CA
Legal business name
RAINBOW OPTOMETRY,INC.
Practice address
1183 E Foothill Blvd # 140
Upland, CA 91786-4049
Phone
(909) 608-0601
Fax
(909) 608-0610
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Authorized official

Name
Dr. Jessica Li-Yi Yuan, O.D.NPI 1881639441
Title
President
Phone
(909) 608-0601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10945T CA Primary

Addresses

Primary practice location

1183 E Foothill Blvd # 140
Upland, CA 91786-4049

Mailing address

1183 E Foothill Blvd
#140
Upland, CA 91786-4049
Phone (909) 608-0601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080506000834 CA Part B Supplier - Clinic/Group Practice 8527147214 Receives reassigned benefits from 1 practitioner
Practice locations: Upland, CA

National Provider Directory

National Provider Directory

Locations

1183 E Foothill Blvd
Ste 140
Upland, CA 91786
Phone (909) 608-0601

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1043416860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD",
            "address_2": "#140",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864049",
            "telephone_number": "909-608-0601",
            "fax_number": "909-608-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD # 140",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864049",
            "telephone_number": "909-608-0601",
            "fax_number": "909-608-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINBOW OPTOMETRY,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "YUAN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LI-YI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-608-0601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10945T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.