Individual provider Active NPI

Cheryl Chia Min Yu, O.D.

  • Optometrist
  • Hacienda Heights, CA
National Provider Identifier
1124274030
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13475 Issued in CA
Practice address
2115 S Hacienda Blvd
Hacienda Heights, CA 91745-4243
Phone
(626) 330-4115
Fax
(626) 330-4116
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13475 CA Primary
Optometrist 152W00000X OD 690 HI

Addresses

Primary practice location

2115 S Hacienda Blvd
Hacienda Heights, CA 91745-4243

Mailing address

2115 S Hacienda Blvd
Hacienda Heights, CA 91745-4243
Phone (626) 330-4115

Other identifiers 1

IdentifierTypeStateIssuer
FI811ZOtherMEDICARE PTAN

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
I20110913000099 CA Practitioner - Optometry 5092986653 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD 690HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jane H Liang OD Inc. Optometrist CurrentSince Dec 10, 2023 Accepting new patients

Locations

2115 S Hacienda Blvd
Hacienda Heights, CA 91745
Phone (626) 330-4115

Organizations & group practices 2

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1124274030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 S HACIENDA BLVD",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917454243",
            "telephone_number": "626-330-4115",
            "fax_number": "626-330-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S HACIENDA BLVD",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917454243",
            "telephone_number": "626-330-4115",
            "fax_number": "626-330-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "CHERYL",
        "middle_name": "CHIA MIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13475",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD 690",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "FI811Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hacienda Heights, CA

Sources for this page

Verify at the official NPI Registry.