Individual provider Active NPI

Jun Wing Chen, OD

  • Optometrist
  • Anaheim, CA
National Provider Identifier
1073354478
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35704 Issued in CA
Practice address
5460 E la Palma Ave
Anaheim, CA 92807-2023
Phone
(714) 449-7404
NPI assigned
Jun 3, 2024
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35704 CA Primary

Addresses

Primary practice location

5460 E la Palma Ave
Anaheim, CA 92807-2023

Mailing address

1303 142ND Ave SE
Bellevue, WA 98007-5542
Phone (425) 628-7944

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240618000590 CA Practitioner - Optometry 1850834953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall B Ketchum UniversityGroup PAC ID 9739075177, 56 clinicians

Practice addresses (Care Compare)

18600 S Figueroa St
Gardena, CA 90248-4505
Phone (310) 325-5111

25821 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013
Phone (562) 986-2200

5460 E la Palma Ave
Anaheim, CA 92807-2023
Phone (714) 463-7520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall B. Ketchum University CurrentSince Jul 1, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 13, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 13, 2025 Accepting new patients
Marshall B. Ketchum University Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

5460 E La Palma Ave
Anaheim, CA 92807
Phone (714) 463-7500

2575 Yorba Linda Blvd
Fullerton, CA 92831
Phone (714) 449-7400

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

3916 S Broadway
Los Angeles, CA 90037
Phone (323) 234-9137

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1073354478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 142ND AVE SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980075542",
            "telephone_number": "425-628-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072023",
            "telephone_number": "714-449-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JUN WING",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5460 E La Palma Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928072023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.