Artesia I Care Optometry
Organization Active NPI Optometrist · Artesia, CA
NPI 1306235387 · NPPES record last updated Jan 14, 2015
Key facts
- NPI
- 1306235387
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 5286 T (CA)
- Legal business name
- ARTESIA I CARE OPTOMETRY
- Practice address
- 11436 Artesia Blvd Ste D
Artesia, CA 90701-3859 - Phone
- (562) 860-1717
- NPI assigned
- Jan 14, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Ken Imoto, O.D.
- Title
- Owner/Optometrist
- Phone
- (562) 860-1717
Practitioners 2
-
Ken Imoto, OD
-
Bryan Takanori Imoto, BRYAN IMOTO O.D.
National Provider Directory
Locations
11436 Artesia Blvd
Ste D
Artesia, CA 90701
Phone (562) 860-1717
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 5286 T | CA | Yes |
Addresses
Primary practice location
11436 Artesia Blvd Ste D
Artesia, CA 90701-3859
Mailing address
11436 Artesia Blvd Ste D
Artesia, CA 90701-3859
Phone (562) 860-1717
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0052860 | Medicaid | CA |
Other providers in Artesia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.