Wada Optometry, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10097T Issued in CA

Legal business name

WADA OPTOMETRY, INC.

Practice address

936 S Brookhurst St
Anaheim, CA 92804-4305

Phone

(714) 533-2525

Fax

(714) 242-9564

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Garrett Scott Wada, ODNPI 1033172903

Title

Optometrist

Phone

(714) 533-2525

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wada Optometry, INC. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

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

• Garrett Scott Wada, OD

  • Optometrist
  • Anaheim, CA
  • NPI 1033172903
  Medicare reassignment NPD Authorized official
• Ryan Funai, OD

  • Optometrist
  • Anaheim, CA
  • NPI 1003537598
  Medicare reassignment NPD
• Michael Edward Poblete, OD

  • Optometrist
  • Phelan, CA
  • NPI 1164196820
  Medicare reassignment

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1184744641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 S BROOKHURST ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044305",
            "telephone_number": "714-533-2525",
            "fax_number": "714-242-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 S BROOKHURST ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044305",
            "telephone_number": "714-533-2525",
            "fax_number": "714-242-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADA OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "WADA",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "714-533-2525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10097T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD010097",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wada Optometry, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olivia Vuong
• Maheshkumar Vyas, M.D.
• Shail M. Vyas, M.D.
• Sujata B. Vyas, MD
• W 2 W Medical Group Inc
• Garrett Scott Wada, OD
• Michael Wade
• Divneet K Wadhwa, MD
• Parvindar Wadhwa
• Joan Lynn Wagner, M.A.

• Optometrist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.