Individual provider Active NPI

Annie Chinwen Hu-Duval, O.D.

  • Corneal and Contact Management Optometrist
  • Los Angeles, CA
National Provider Identifier
1073576179
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
11896T Issued in CA
Practice address
1059 Gayley Ave
Los Angeles, CA 90024-3401
Phone
(310) 208-3604
Fax
(310) 208-6831
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 11896T CA Primary

Addresses

Primary practice location

1059 Gayley Ave
Los Angeles, CA 90024-3401

Mailing address

1059 Gayley Ave
Los Angeles, CA 90024-3401
Phone (310) 208-3604

Other identifiers 2

IdentifierTypeStateIssuer
W22097OtherCAMEDICARE GROUP PTAN
GY195AOtherCAMEDICARE PTAN

Other names 1

  • Annie Chinwen Hu Other name

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
I20040130001105 CA Practitioner - Optometry 8325941826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jon D Vogel OD a Professional CorpGroup PAC ID 5496833568, 4 clinicians

Practice addresses (Care Compare)

1059 Gayley Ave
Los Angeles, CA 90024-3401
Phone (310) 208-3011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11896TCAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jon D. Vogel, O.D. a Professional Corp CurrentSince Dec 17, 2012 Accepting new patients
Ryan Taban, M.D., Inc. Past Accepting new patients
Jules Stein Eye Institute Medical Group Past Accepting new patients

Locations

1069 Broxton Ave
Los Angeles, CA 90024
Phone (310) 208-3011

1059 Gayley Ave
Los Angeles, CA 90024
Phone (310) 208-3011

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1073576179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 GAYLEY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243401",
            "telephone_number": "310-208-3604",
            "fax_number": "310-208-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 GAYLEY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243401",
            "telephone_number": "310-208-3604",
            "fax_number": "310-208-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HU-DUVAL",
        "first_name": "ANNIE",
        "middle_name": "CHINWEN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "11896T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "W22097",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GY195A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "HU",
            "middle_name": "CHINWEN",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.