Lani Kiku Hirota Wilson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12078T Issued in CA

Practice address

5789 Mission Center Rd Apt 315
(Note: Residential. No Business Location Yet)
San Diego, CA 92108-4916

Phone

(916) 521-3269

NPI assigned

Jul 12, 2006

Last updated

Jun 20, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Norfolk Eye Physicians & Surgeons

  • Eyewear Supplier
  • Norfolk, VA
  • NPI 1033242219
  NPD (past)
• Norfolk Eye Physicians & Surgeons LTD.

  • Ophthalmology Physician
  • Norfolk, VA
  • NPI 1720146087
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1356366546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5789 MISSION CENTER RD",
            "address_2": "APT. 315",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084316",
            "telephone_number": "916-521-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5789 MISSION CENTER RD APT 315",
            "address_2": "(NOTE: RESIDENTIAL. NO BUSINESS LOCATION YET)",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084916",
            "telephone_number": "916-521-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LANI",
        "middle_name": "KIKU HIROTA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001417",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12078T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYMENT IDENTIFICATION",
            "identifier": "680437386",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen R Wilson, M.S.
• Kasey Wilson
• Katherine Wilson, MD
• Kera Wilson, APCC
• Kiana Michelle Wilson
• Laurel Wilson
• Lindsay Elizabeth Wilson
• Lori Anne Wilson, L.AC.
• Marcella M. Wilson, MD
• Mark Wilson, MOT OTR/L

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; 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.