Eye Studio Optometry Inc

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

12792 Issued in CA

Legal business name

EYE STUDIO OPTOMETRY INC

Practice address

4475 University Ave
San Diego, CA 92105-1731

Phone

(619) 618-2954

Fax

(619) 618-2954

NPI assigned

Aug 6, 2008

Last updated

Jul 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leslie Chen, O.D.NPI 1508953332

Title

President

Phone

(619) 521-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leslie L Chen, O.D.

  • Corneal and Contact Management Optometrist
  • San Diego, CA
  • NPI 1508953332
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1356507503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051731",
            "telephone_number": "619-521-2025",
            "fax_number": "619-521-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051731",
            "telephone_number": "619-618-2954",
            "fax_number": "619-618-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE STUDIO OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-521-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "12792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356507503",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eye Connection Optometry, Inc
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• Eyelux Optometry
• Eyes for Kids and Teens
• Eyesmith, a Professional Optometry Corporation

• Corneal and Contact Management Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Corneal and Contact Management Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.