Eyegen Vision Center Optometry, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

10300 Issued in CA

Legal business name

EYEGEN VISION CENTER OPTOMETRY, INC

Practice address

16845 Algonquin St
Huntington Beach, CA 92649-3810

Phone

(714) 841-9888

Fax

(714) 841-9555

NPI assigned

Aug 30, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Ana Chang-SmithNPI 1639242019

Title

President

Phone

(714) 841-9888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Ana Chang Smith, OD

  • Optometrist
  • Huntington Beach, CA
  • NPI 1639242019
  Medicare reassignment Care Compare group Authorized official
• Gregory W Smith, OD

  • Optometrist
  • Huntington Beach, CA
  • NPI 1184797557
  Medicare reassignment Care Compare group
• Jillian S Gray, D.O.

  • Internal Medicine Physician
  • Huntington Beach, CA
  • NPI 1639296957
  NPD (past)

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1053745679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16835 ALGONQUIN ST",
            "address_2": "SUITE 383",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493810",
            "telephone_number": "714-841-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16845 ALGONQUIN ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493810",
            "telephone_number": "714-841-9888",
            "fax_number": "714-841-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEGEN VISION CENTER OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "CHANG-SMITH",
        "authorized_official_first_name": "ANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-841-9888",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Douglass Ewing, M.D.
• Excellent Community Healthcare Center
• Leslie Exconde, REGISTERED NURSE
• Eyecare Specialists Medical Group, Inc
• Eyecare Specialists Medical Group, Inc. (Atlantis Eyecare)
• Kelli Rose Ezell, LCSW
• F & N Pharma Inc (West Pharmacy)
• F & N Pharma Inc (West Drug)
• Antoine K Fahd, M.D.
• Fred Fahimy, D.D.S.

• Optometrist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.