Tetsuji C Kita, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10704T Issued in CA

Practice address

1322 Broadway
Burlingame, CA 94010-3426

Phone

(650) 343-4916

Fax

(650) 343-6920

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1255366829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 ROBLE RD",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302938",
            "telephone_number": "650-259-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 BROADWAY",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103426",
            "telephone_number": "650-343-4916",
            "fax_number": "650-343-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITA",
        "first_name": "TETSUJI",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10704T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0107040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kinnen
• Joanne Kathleen Kinyon, ATC
• Michael R. Kinzinger, M.D.
• Bruce Irwin Kirschner, M.D.
• Eugene Tetsuo Kita, DDS
• Kjowerconsulting Inc
• Tabitha Kim Kleiner
• Masha Kleusch-Mekhteys, D.D.S.
• David C. Klonoff, M.D.
• Angela Knox, RN

• Optometrist in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.