Connie K Ha OD, Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

11141 Issued in CA

Legal business name

CONNIE K HA OD, PROFESSIONAL CORPORATION

Doing business as

San Bruno Eye Care Center

Practice address

931 San Bruno Ave W RM 4
San Bruno, CA 94066-3435

Phone

(650) 588-7701

Fax

(650) 588-7797

NPI assigned

Jun 12, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Connie Ha, O.D.NPI 1700807369

Title

President

Phone

(650) 588-7701

Specialties & licenses 1

Addresses

Other names 1

• San Bruno Eye Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Connie Ha, O.D.

  • Optometrist
  • San Bruno, CA
  • NPI 1700807369
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1205198520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 SAN BRUNO AVE W RM 4",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663435",
            "telephone_number": "650-588-7701",
            "fax_number": "650-588-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 SAN BRUNO AVE W RM 4",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663435",
            "telephone_number": "650-588-7701",
            "fax_number": "650-588-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNIE K HA OD, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "HA",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-588-7701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Bruno Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harley Irene Coit
• Elisha Coleman
• Kahreemah Coleman
• Donald Brian Conkling, DVM
• Crystalee Connelly
• Therese Connolly, LCSW
• Kaebeth Contreras
• William Richardson Cooper II
• Veronica Coppolino
• Lydia Iris Cordonero, MSW INTERN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.