Optometric Eye Institute PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

12236T Issued in CA

Legal business name

OPTOMETRIC EYE INSTITUTE PC

Practice address

842 S Broadway
Los Angeles, CA 90014

Phone

(213) 627-9771

Fax

(213) 627-3146

NPI assigned

Oct 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Teresa Chang, O.D.

Title

Owner

Phone

(213) 627-9771

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roxana Gilda De la Rosa, O.D.

  • Optometrist
  • Los Angeles, CA
  • NPI 1003048588
  NPD (past)

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1306025390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 S BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90014",
            "telephone_number": "213-627-9771",
            "fax_number": "213-627-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 S BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90014",
            "telephone_number": "213-627-9771",
            "fax_number": "213-627-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC EYE INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-627-9771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12236T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "W18409",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optimum Home Health Care Services, Inc.
• Optimum Touch Home Health Care Inc
• Optimum Urgent Care
• Optimum Wellness Therapy
• Opto Bar Optometric Inc
• Optometric Eyesite Inc
• Optometric Specialties Inc
• Optometrix
• Optumcare Management, LLC
• Optumcare Management, LLC

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.