Michael Wang, OD, a Professional Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT15191 Issued in CA

Legal business name

MICHAEL WANG, OD, A PROFESSIONAL OPTOMETRIC CORPORATION

Practice address

10066 Pacific Heights Blvd
Suite 112
San Diego, CA 92121-4211

Phone

(858) 526-0890

Fax

(858) 526-0899

NPI assigned

May 11, 2015

Organization subpart

No

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

Authorized official

Name

Michael Wang, O. D.

Title

President

Phone

(858) 526-0890

Specialties & licenses 1

Addresses

Other names 1

• Designer Eyes Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mingjun Michael Wang, O. D.

  • Optometrist
  • San Diego, CA
  • NPI 1770569386
  Medicare reassignment NPD

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1184002172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10066 PACIFIC HEIGHTS BLVD",
            "address_2": "SUITE 112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214211",
            "telephone_number": "858-526-0890",
            "fax_number": "858-526-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10066 PACIFIC HEIGHTS BLVD",
            "address_2": "SUITE 112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214211",
            "telephone_number": "858-526-0890",
            "fax_number": "858-526-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WANG, OD, A PROFESSIONAL OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-526-0890",
        "authorized_official_credential": "O. D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT15191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Designer Eyes Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael S Duffy Sr DO Inc
• Michael S Singer DDS Inc
• Michael Song MD a Professional Medical Corporation
• Michael T Couris MD Inc
• Michael T Lardon MD Apc
• Georgina Maxine Michael, NP
• Leyla Michael
• Madeline Michael
• Olivia G Michael
• Rezene Michael, RN

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.