Individual provider Active NPI

Ford Scott Takaichi, ABO

  • Optician
  • Capitola, CA
National Provider Identifier
1093055238
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
183993 Issued in CA
Practice address
3555 Clares St
Suite H
Capitola, CA 95010-2555
Phone
(831) 477-4900
Fax
(831) 477-4909
NPI assigned
Feb 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 183993 CA Primary

Addresses

Primary practice location

3555 Clares St
Suite H
Capitola, CA 95010-2555

Mailing address

3555 Clares St
Suite H
Capitola, CA 95010-2555
Phone (831) 477-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
183993CAMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1093055238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 CLARES ST",
            "address_2": "SUITE H",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102555",
            "telephone_number": "831-477-4900",
            "fax_number": "831-477-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 CLARES ST",
            "address_2": "SUITE H",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102555",
            "telephone_number": "831-477-4900",
            "fax_number": "831-477-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKAICHI",
        "first_name": "FORD",
        "middle_name": "SCOTT",
        "credential": "ABO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "183993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.