Angela J Kwak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13692OPT Issued in CA

Practice address

500 S Anaheim Hills Rd Ste 234
Anaheim, CA 92807-4760

Phone

(800) 898-2020

NPI assigned

Aug 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Tedder Optometric Corporation, PC

  • Optometrist
  • Lake Forest, CA
  • NPI 1679262158
  Medicare reassignment NPD
• Hansra Optometric Corporation

  • Eyewear Supplier
  • Sacramento, CA
  • NPI 1366258436
  NPD
• Barry a. Katzman, M.D., Inc Apc

  • Optometrist
  • San Diego, CA
  • NPI 1588842488
  NPD (past)
• Jean Hojin Kim, OD, Inc.

  • Optometrist
  • West Covina, CA
  • NPI 1528089661
  NPD (past)
• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)

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

{
    "created_epoch": "1251590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1255564860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS RD STE 234",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074760",
            "telephone_number": "800-898-2020",
            "fax_number": "844-897-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS RD STE 234",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074760",
            "telephone_number": "800-898-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44815 Fig Ave",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935343144",
            "country_code": "US",
            "telephone_number": "800-898-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 W El Norte Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920263923",
            "country_code": "US",
            "telephone_number": "800-898-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44139 Monterey Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922608700",
            "country_code": "US",
            "telephone_number": "800-898-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWAK",
        "first_name": "ANGELA",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-30",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13692OPT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tjahjadi Andy Kusumo, DDS
• George M Kusztyk, OD
• Joseph D Kuwahara, MD
• KW Youn DDS Dental Corporation
• Aeri Kwak
• Jeneve Fern Kwan, PT
• Joseph Anthony Kwee, M.D.
• Christina Health Kwon
• Derek Soon Kwon, OD
• Soonsi Kwon, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.