Individual provider Active NPI

Isabel Duong, OD

  • Optometrist
  • Torrance, CA
National Provider Identifier
1215421367
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33977 Issued in CA
Practice address
23600 Telo Ave Ste 100
Torrance, CA 90505-4036
Phone
(310) 543-2611
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 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 33977 CA Primary

Addresses

Primary practice location

23600 Telo Ave Ste 100
Torrance, CA 90505-4036

Mailing address

3280 Provon LN Apt 1
Los Angeles, CA 90034-2742
Phone (425) 208-6094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181017000974 CA Practitioner - Optometry 2062764269 Reassigns benefits to 1 organization
I20190820002876 WA Practitioner - Optometry 2062764269 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33977CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rainier Valley Optometric, Inc Optometrist CurrentSince Jul 1, 2019 Accepting new patients
John E. Maanum, O.D. Optometrist PastSince Sep 5, 2018 Accepting new patients

Locations

7101 Martin Luther King Jr Way S
Ste 209
Seattle, WA 98118
Phone (206) 722-2218

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1215421367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 PROVON LN APT 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342742",
            "telephone_number": "425-208-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23600 TELO AVE STE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054036",
            "telephone_number": "310-543-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "ISABEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.