Individual provider Active NPI

David Yoo, O.D.

  • Optometrist
  • Marina del Rey, CA
National Provider Identifier
1093178410
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT15336TLG Issued in CA
Practice address
13463 Washington Blvd
Marina del Rey, CA 90292-5658
Phone
(310) 821-8382
NPI assigned
Apr 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT15336TLG CA Primary

Addresses

Primary practice location

13463 Washington Blvd
Marina del Rey, CA 90292-5658

Mailing address

13463 Washington Blvd
Marina del Rey, CA 90292-5658
Phone (310) 821-8382

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
I20190628002578 CA Practitioner - Optometry 0143554808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel E. Quon, O.D. Inc.Group PAC ID 2769427806, 2 clinicians

Practice addresses (Care Compare)

949 S Coast Dr
Suite 155
Costa Mesa, CA 92626-7838
Phone (714) 540-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT15336TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel E. Quon, O.D. Inc. Optometrist CurrentSince Apr 14, 2019 Accepting new patients

Locations

949 S Coast Dr
Ste 155
Costa Mesa, CA 92626
Phone (714) 540-2020

Organizations & group practices 1

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": "1459555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1093178410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13463 WASHINGTON BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925658",
            "telephone_number": "310-821-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13463 WASHINGTON BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925658",
            "telephone_number": "310-821-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-02",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT15336TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.