Kelly Lao OD Apc

Primary specialty

OptometristTaxonomy code 152W00000X

License

10646T Issued in CA

Legal business name

KELLY LAO OD APC

Practice address

240 Meridian Ave
Ste 1
San Jose, CA 95126

Phone

(408) 293-7576

Fax

(408) 293-7579

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Lao Seng, OD

Title

President

Phone

(408) 293-7576

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Kelly Lao, O.D.

  • Optometrist
  • San Jose, CA
  • NPI 1043406697
  Medicare reassignment

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1215955141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MERIDIAN AVE",
            "address_2": "STE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95126",
            "telephone_number": "408-293-7576",
            "fax_number": "408-293-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MERIDIAN AVE",
            "address_2": "STE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95126",
            "telephone_number": "408-293-7576",
            "fax_number": "408-293-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY LAO OD APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "SENG",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LAO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-293-7576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10646T",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley Park Medical Clinic, Inc
• Nirvair Singh Kelley, D.O.
• Roselle Dizon Kelley, PT
• John S. Kellogg, M.D., M.S.
• Kelly Kao Acupuncture &Wellness Center Professional Corporation
• Kelly Thanh DDS, Inc
• Patience Kelly-Wilson
• Emily Kelly
• Jamaica Kelly, BEHAVIORAL TECH
• Marypat Kelly, GNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.