East Bay Vision Center Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

8533T Issued in CA

Legal business name

EAST BAY VISION CENTER OPTOMETRY INC

Practice address

34420 Fremont Blvd
Ste E
Fremont, CA 94555-3323

Phone

(510) 796-9600

Fax

(510) 796-9691

NPI assigned

Mar 5, 2007

Organization subpart

Yes

Parent organization

EAST BAY VISION CENTER OPTOMETRYAs reported in NPPES

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

Authorized official

Name

Dr. Eileen S Lo, O.D.

Title

Optometrist

Phone

(510) 796-9600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• East Bay Vision Center Optometry Inc

  • Optometrist
  • Oakland, CA
  • NPI 1396779344

  O20050120000949

  Same enrollment

Part of

East Bay Vision Center Optometry Inc

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• East Bay Vision Center Optometry Inc

  • Optometrist
  • Oakland, CA
  • NPI 1396779344
  NPPES parent name

Practitioners 3

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

• Camellia Lee, OD

  • Optometrist
  • Oakland, CA
  • NPI 1518697838
  NPD
• Eileen S Lee, O.D.

  • Optometrist
  • Oakland, CA
  • NPI 1851355309
  NPD
• Rebecca Y Lee, O.D.

  • Optometrist
  • Oakland, CA
  • NPI 1841642295
  NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298851200000",
    "number": "1083743066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34420 FREMONT BLVD",
            "address_2": "STE E",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945553323",
            "telephone_number": "510-796-9600",
            "fax_number": "510-796-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34420 FREMONT BLVD",
            "address_2": "STE E",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945553323",
            "telephone_number": "510-796-9600",
            "fax_number": "510-796-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY VISION CENTER OPTOMETRY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST BAY VISION CENTER OPTOMETRY",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-02-28",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "510-796-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8533T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0085332",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Bay Dermatology Medical Group Inc
• East Bay Eye Centers Medical Corporation
• East Bay Eyecare Professionals, Inc.
• East Bay Hand & Plastic Surgery Center Inc.
• East Bay Retina Consultants a Medical Group, Inc.
• East Bay Weight Control, Inc
• Vaishvi D Ebrado
• Ebrahim Ahmadi, M D Inc.
• Henna Ebrahimi
• Ed Sped Solutions, Inc.

• Optometrist in Fremont, CA
• Providers in Fremont, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.