Individual provider Active NPI

Christina Wong Grattan, O.D.

  • Optometrist
  • Torrance, CA
National Provider Identifier
1194150953
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14709 Issued in CA
Practice address
4825 Torrance Blvd Ste 100
Torrance, CA 90503-4167
Phone
(310) 937-6585
Fax
(310) 542-3809
NPI assigned
Sep 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14709 CA Primary

Addresses

Primary practice location

4825 Torrance Blvd Ste 100
Torrance, CA 90503-4167

Mailing address

4825 Torrance Blvd Ste 100
Torrance, CA 90503-4167
Phone (310) 937-6585

Other names 1

  • Christina Wong Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140529000234 CA Practitioner - Optometry 1759504301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

4825 Torrance Blvd
Suite 100
Torrance, CA 90503-4167
Phone (310) 937-6585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince Jul 1, 2023 Accepting new patients
Providence Medical Institute Current Accepting new patients
Providence Medical Institute CurrentSince Jul 1, 2023 Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

621 S Butte St
San Pedro, CA 90732
Phone (310) 548-1422

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

4825 Torrance Blvd
Ste 100
Torrance, CA 90503
Phone (310) 937-6585

4825 Torrance Blvd
Ste 102
Torrance, CA 90503
Phone (310) 214-0088

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1194150953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 TORRANCE BLVD STE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034167",
            "telephone_number": "310-937-6585",
            "fax_number": "310-542-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 TORRANCE BLVD STE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034167",
            "telephone_number": "310-937-6585",
            "fax_number": "310-542-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRATTAN",
        "first_name": "CHRISTINA",
        "middle_name": "WONG",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "WONG",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.