Jeff Kaku, O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8963TL Issued in CA

Legal business name

JEFF KAKU, O.D., INC.

Practice address

2001 E Chapman Ave
Fullerton, CA 92831-4105

Phone

(714) 738-6902

Fax

(714) 738-0296

NPI assigned

Mar 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffery Hitoshi Kaku, O.D.

Title

President

Phone

(714) 738-6902

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1356301469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314105",
            "telephone_number": "714-738-6902",
            "fax_number": "714-738-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314105",
            "telephone_number": "714-738-6902",
            "fax_number": "714-738-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF KAKU, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KAKU",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "HITOSHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-738-6902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8963TL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0089630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.