Individual provider Active NPI

Katherine Lok Chan, OD

  • Optometrist
  • San Mateo, CA
National Provider Identifier
1336302637
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11078T Issued in CA
Practice address
138 E 3Rd Ave
San Mateo, CA 94401-4013
Phone
(650) 348-8818
NPI assigned
Jul 7, 2008
Last updated
Jul 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11078T CA Primary

Addresses

Primary practice location

138 E 3Rd Ave
San Mateo, CA 94401-4013

Mailing address

138 E 3Rd Ave
San Mateo, CA 94401-4013
Phone (650) 348-8818

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
I20031203000147 CA Practitioner - Optometry 3577468693 Practice locations: San Mateo, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11078CAMDGeneral Practice Dentistry
11078TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Optometry Optometrist PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1336302637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 E 3RD AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944014013",
            "telephone_number": "650-348-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 E 3RD AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944014013",
            "telephone_number": "650-348-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOK CHAN",
        "first_name": "KATHERINE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11078T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.