Dr Luque OD, Apoc

Primary specialty

OptometristTaxonomy code 152W00000X

License

11937TLG Issued in CA

Legal business name

DR LUQUE OD, APOC

Practice address

26471 Carl Boyer Dr
Santa Clarita, CA 91350-2996

Phone

(661) 288-2068

Fax

(866) 926-9833

NPI assigned

Sep 20, 2011

Organization subpart

No

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

Authorized official

Name

Lee-Jiuan Luque, OD

Title

President

Phone

(661) 942-7007

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1083997746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801002",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913801002",
            "telephone_number": "661-942-7007",
            "fax_number": "866-926-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26471 CARL BOYER DR",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502996",
            "telephone_number": "661-288-2068",
            "fax_number": "866-926-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR LUQUE OD, APOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "LUQUE",
        "authorized_official_first_name": "LEE-JIUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-942-7007",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11937TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0119370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.