Individual provider Active NPI

Anna Lam, O.D.

  • Optometrist
  • North Hollywood, CA
National Provider Identifier
1316353220
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15054 Issued in CA
Practice address
12000 Victory Blvd
North Hollywood, CA 91606-3319
Phone
(818) 985-2321
NPI assigned
Jul 11, 2014
Last updated
Jul 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15054 CA Primary

Addresses

Primary practice location

12000 Victory Blvd
North Hollywood, CA 91606-3319

Mailing address

20406 Gilmore St
Winnetka, CA 91306-4216
Phone (818) 671-8250

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141124002082 CA Practitioner - Optometry 2062734247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2850 N Oxnard Blvd
Oxnard, CA 93036-5443
Phone (805) 981-8580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15054CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anna Lam O.D. Inc. CurrentSince May 9, 2015 Accepting new patients
Andrew Babayan, OD, Apc. Optometrist PastSince May 8, 2022 Accepting new patients
Barry a Wagner OD a Professional Corporation Optometrist Past Accepting new patients

Locations

2850 N Oxnard Blvd
Oxnard, CA 93036
Phone (805) 288-3643

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1316353220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20406 GILMORE ST",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913064216",
            "telephone_number": "818-671-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063319",
            "telephone_number": "818-985-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.