Active NPI
Steven Kenji Moriyasu, O.D.
- Optometrist
- Covina, CA
National Provider Identifier
1124153796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10383T
- Practice address
- 924 N Citrus Ave
Covina, CA 91722-2737 - Phone
- (626) 331-2020
- NPI assigned
- Feb 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 10383T | CA | Primary |
Addresses
Primary practice location
924 N Citrus Ave
Covina, CA 91722-2737
Mailing address
4863 Kennedy LN
Yorba Linda, CA 92886-3387
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10383T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moriyasu Optometry Inc. | Optometrist | Current | Accepting new patients |
Locations
924 N Citrus Ave
Covina, CA 91722
Phone (626) 331-2020
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124153796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4863 KENNEDY LN",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928863387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "924 N CITRUS AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917222737",
"telephone_number": "626-331-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORIYASU",
"first_name": "STEVEN",
"middle_name": "KENJI",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10383T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.