Woodbury Family Optometry

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

11134TPL Issued in CA

Legal business name

WOODBURY FAMILY OPTOMETRY

Practice address

6270 Irvine Blvd
Irvine, CA 92620-2103

Phone

(949) 786-0143

Fax

(949) 786-0492

NPI assigned

Jan 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Atsuo Fukuda, O.D.NPI 1497764864

Title

Owner

Phone

(949) 786-0143

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kenneth Atsuo Fukuda, O.D.

  • Optometrist
  • Irvine, CA
  • NPI 1497764864
  NPD (past) Authorized official

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1194020347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6270 IRVINE BLVD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202103",
            "telephone_number": "949-786-0143",
            "fax_number": "949-786-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6270 IRVINE BLVD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202103",
            "telephone_number": "949-786-0143",
            "fax_number": "949-786-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBURY FAMILY OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "FUKUDA",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ATSUO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-786-0143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "11134TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA OPTOMETRY LICENSE",
            "identifier": "11134TPL",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Gail Wood, LMFT, APCC
• Joshua Woodard
• Woodbridge Optometry
• Woodbridge Optometry, Inc.
• Woodbury Associates, LLC
• Rebecca Ellen Woode, BCBA
• Mirae Woodruff
• Robert L Woods, MD
• Janna Woodward, OTR/L
• Veronica Woodward

• Clinic/Center in Irvine, CA
• Providers in Irvine, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.