NPIMap

Organization Active NPI

Woodbridge Optometry

  • Optometrist
  • Irvine, CA
National Provider Identifier
1184992281
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7839T Issued in CA
Legal business name
WOODBRIDGE OPTOMETRY
Practice address
4040 Barranca Pkwy
Suite 110
Irvine, CA 92604-4766
Phone
(949) 857-0676
Fax
(949) 857-2175
NPI assigned
Dec 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Authorized official

Name
Christopher Paul Likens, O.D.NPI 1497827935
Title
Owner
Phone
(949) 857-0676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 7839T CA Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 8038T CA
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 14184T CA
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 8049T CA

Addresses

Primary practice location

4040 Barranca Pkwy
Suite 110
Irvine, CA 92604-4766

Mailing address

4040 Barranca Parkway
Suite 110
Irvine, CA 92604-4772
Phone (949) 857-0676

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ68757YOtherCABLUE SHILED PIN

National Provider Directory

National Provider Directory

Locations

4040 Barranca Pkwy
Ste 110
Irvine, CA 92604
Phone (949) 857-0676

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1184992281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 BARRANCA PARKWAY",
            "address_2": "SUITE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044772",
            "telephone_number": "949-857-0676",
            "fax_number": "949-857-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 BARRANCA PKWY",
            "address_2": "SUITE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044766",
            "telephone_number": "949-857-0676",
            "fax_number": "949-857-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBRIDGE OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "LIKENS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-857-0676",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7839T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8038T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14184T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8049T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHILED PIN",
            "identifier": "ZZZ68757Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.