Laguna Creek Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

8208T Issued in CA

Legal business name

LAGUNA CREEK OPTOMETRY

Practice address

5050 Laguna Blvd
#113
Elk Grove, CA 95758-4151

Phone

(916) 684-7070

Fax

(916) 684-8048

NPI assigned

Jun 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Darrell Chin, O.D.

Title

Owner/Optometrist

Phone

(916) 684-7070

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Drs. Chin & Chin, O.D.s Other name

Locations

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1255590238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 LAGUNA BLVD",
            "address_2": "#113",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584151",
            "telephone_number": "916-684-7070",
            "fax_number": "916-684-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 LAGUNA BLVD",
            "address_2": "#113",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584151",
            "telephone_number": "916-684-7070",
            "fax_number": "916-684-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGUNA CREEK OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "CHIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "DARRELL",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "916-684-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8208T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0082080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs. Chin & Chin, O.D.s",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Laguna Pharmacy Inc
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• Laguna Physical Therapy & Hand Rehabilitation

• Optometrist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.