Organization Active NPI

Cupertino Village Optometry, Apc

  • Optometrist
  • Cupertino, CA
National Provider Identifier
1043640675
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12434TPL Issued in CA
Legal business name
CUPERTINO VILLAGE OPTOMETRY, APC
Practice address
10969 N Wolfe Rd
Cupertino, CA 95014-0617
Phone
(408) 873-1718
Fax
(408) 873-1026
NPI assigned
Nov 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Kai Shum
Title
Cfo
Phone
(408) 873-1718

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 12434TPL CA Primary

Addresses

Primary practice location

10969 N Wolfe Rd
Cupertino, CA 95014-0617

Mailing address

10969 N Wolfe Rd
Cupertino, CA 95014-0617
Phone (408) 873-1718

National Provider Directory

National Provider Directory

Locations

10969 N Wolfe Rd
Cupertino, CA 95014
Phone (408) 873-1718

Practitioners & affiliated clinicians

Practitioners 2

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": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1043640675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10969 N WOLFE RD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950140617",
            "telephone_number": "408-873-1718",
            "fax_number": "408-873-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10969 N WOLFE RD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950140617",
            "telephone_number": "408-873-1718",
            "fax_number": "408-873-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUPERTINO VILLAGE OPTOMETRY, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "SHUM",
        "authorized_official_first_name": "KAI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "408-873-1718"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12434TPL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.