Individual provider Active NPI

Celeste Lien Pinkham, O.D.

  • Optometrist
  • La Habra, CA
National Provider Identifier
1245373406
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT11205TPA Issued in CA
Practice address
601 E Whittier Blvd
Suite 102
La Habra, CA 90631-3972
Phone
(562) 697-6733
Fax
(562) 697-8303
NPI assigned
Feb 15, 2007
Last updated
Jul 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT11205TPA CA Primary

Addresses

Primary practice location

601 E Whittier Blvd
Suite 102
La Habra, CA 90631-3972

Mailing address

601 E Whittier Blvd
Suite 102
La Habra, CA 90631-3972
Phone (562) 697-6733

Other identifiers 1

IdentifierTypeStateIssuer
SC0112050MedicaidCA

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
I20080313000576 CA Practitioner - Optometry 8628153723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 E Whittier Blvd
Suite 102
La Habra, CA 90631-3972
Phone (562) 697-6733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT11205TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
La Habra Hills Optometry, Inc. Optometrist CurrentSince Oct 1, 2007 Accepting new patients

Locations

601 E Whittier Blvd
Ste 102
La Habra, CA 90631
Phone (562) 697-6733

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1245373406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E WHITTIER BLVD",
            "address_2": "SUITE 102",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313972",
            "telephone_number": "562-697-6733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E WHITTIER BLVD",
            "address_2": "SUITE 102",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313972",
            "telephone_number": "562-697-6733",
            "fax_number": "562-697-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKHAM",
        "first_name": "CELESTE",
        "middle_name": "LIEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT11205TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SC0112050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

Verify at the official NPI Registry.