Tedder Optometry Group, PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TEDDER OPTOMETRY GROUP, PC

Practice address

939 W Arrow Hwy
San Dimas, CA 91773-2410

Phone

(805) 624-1255

NPI assigned

Mar 19, 2024

Last updated

Sep 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Tedder, ODNPI 1477606945

Title

Ceo

Phone

(805) 624-1255

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Catherine Lam, OD

  • Optometrist
  • Culver City, CA
  • NPI 1467123521
  Medicare reassignment Care Compare group NPD
• Coreeliza J Sun, OD

  • Optometrist
  • Lake Forest, CA
  • NPI 1568957678
  Medicare reassignment Care Compare group NPD
• Jeanie Tran, OD

  • Optometrist
  • Santa Clarita, CA
  • NPI 1043857832
  Medicare reassignment Care Compare group NPD
• David Nguyen, OD

  • Optometrist
  • Yorba Linda, CA
  • NPI 1427710821
  Medicare reassignment NPD
• Taylor D Tedder, O.D.

  • Optometrist
  • Moorpark, CA
  • NPI 1639364532
  Medicare reassignment NPD
• James Daniel Abel, OD

  • Optometrist
  • Renton, WA
  • NPI 1255945390

  CA

  Medicare reassignment NPD
• Kimberly A Tedder, O.D.

  • Optometrist
  • Moorpark, CA
  • NPI 1477606945
  NPD Authorized official
• Mai-Anh Bui, O.D.

  • Optometrist
  • Torrance, CA
  • NPI 1396999603
  NPD (past)
• Laura Leticia Garnica, OD

  • Optometrist
  • Colton, CA
  • NPI 1598348468
  NPD (past)
• Phoebe Hoang, OD

  • Optometrist
  • Culver City, CA
  • NPI 1558154104
  NPD (past)
• Cristalle Kwok, OD

  • Optometrist
  • Riverside, CA
  • NPI 1801618103
  NPD (past)
• Sara Shahid Noori, OD

  • Optometrist
  • Los Angeles, CA
  • NPI 1477248912
  NPD (past)

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1184484222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NEW LOS ANGELES AVE STE 115-269",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930212081",
            "telephone_number": "805-624-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 W ARROW HWY",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732410",
            "telephone_number": "805-624-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEDDER OPTOMETRY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "TEDDER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-624-1255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Tang, RPH
• Hannah Tanner
• Erin Camille Tayag
• Janet L Taylor
• Jeffery Taylor
• Francisco Xavier Teran
• Jacquelyn Terranova
• Johnny Thai
• The First Butler Inc (Body Butler Spa)
• The Nursing Practice, Inc. (Pathways Hospice & Palliative Care)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.