Vision San Gabriel Optometry, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

11494T Issued in CA

Legal business name

VISION SAN GABRIEL OPTOMETRY, INC.

Practice address

720 E Valley Blvd
San Gabriel, CA 91776-3547

Phone

(626) 288-8097

Fax

(626) 288-8360

NPI assigned

Mar 6, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Y. Chung, O.D.NPI 1194818518

Title

President

Phone

(626) 288-8097

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Chung, O.D.

  • Optometrist
  • San Gabriel, CA
  • NPI 1194818518
  NPD (past) Authorized official
• Jane Kim, O.D.

  • Optometrist
  • Pasadena, CA
  • NPI 1891874574
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225168719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763547",
            "telephone_number": "626-288-8097",
            "fax_number": "626-288-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763547",
            "telephone_number": "626-288-8097",
            "fax_number": "626-288-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SAN GABRIEL OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-288-8097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11494T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0114940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nithia Venkatessan
• Kathleen Mary Venne, SLPA
• Devin Vergo, PPS
• Viewpoint Pharmacy
• Michelle Escobar Villarino
• Vista Cove at San Gabriel, Inc.
• Vista Cove Care Center at San Gabriel, Inc. (Vista Cove Care Center at San Gabriel)
• W Richard Bukata MD Inc. (San Gabriel Emergency Medicine)
• W. Richard Bukata
• Sze Man Wah, NP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.