Individual provider Active NPI

Chunming Liu, OD

  • Optometrist
  • Pomona, CA
National Provider Identifier
1346541901
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT14079TLG Issued in CA
Practice address
795 E 2ND St
Suite 2
Pomona, CA 91766-2007
Phone
(909) 706-3899
Fax
(909) 469-8640
NPI assigned
Nov 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 14079TLG CA
Optometrist 152W00000X OPT14079TLG CA Primary
Sports Vision Optometrist 152WS0006X 14079TLG CA
Vision Therapy Optometrist 152WV0400X 14079TLG CA

Addresses

Primary practice location

795 E 2ND St
Suite 2
Pomona, CA 91766-2007

Mailing address

795 E 2ND St
Suite 2
Pomona, CA 91766-2007
Phone (909) 469-8773

Other identifiers 1

IdentifierTypeStateIssuer
CB204341OtherCAMEDICARE PTAN SO CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT14079TLGCAMDOptometrist
14079TLGCAMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific University Optometrist Current Accepting new patients

Locations

2043 College Way
Forest Grove, OR 97116
Phone (503) 352-2020

222 SE 8th Ave
Ste 114
Hillsboro, OR 97123
Phone (503) 352-7300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1346541901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 E 2ND ST",
            "address_2": "SUITE 2",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-469-8773",
            "fax_number": "909-469-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 E 2ND ST",
            "address_2": "SUITE 2",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-706-3899",
            "fax_number": "909-469-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "CHUNMING",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-12",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "14079TLG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT14079TLG",
            "primary": true
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "14079TLG",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "14079TLG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN SO CAL",
            "identifier": "CB204341",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.