Mark S. Ichikawa, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

7965T Issued in CA

Practice address

596 E El Camino Real
Suite 2
Sunnyvale, CA 94087-1940

Phone

(408) 245-6212

NPI assigned

Jul 5, 2006

Last updated

Sep 13, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mark S Ichikawa, OD

  dba Sunnyvale Optometry

  • Optometrist
  • Sunnyvale, CA
  • NPI 1477595007
  Authorized official Same address or phone

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1285665992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 E EL CAMINO REAL",
            "address_2": "SUITE 2",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940871940",
            "telephone_number": "408-245-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 E EL CAMINO REAL",
            "address_2": "SUITE 2",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940871940",
            "telephone_number": "408-245-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICHIKAWA",
        "first_name": "MARK",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7965T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.