Individual provider Active NPI

Keith Tio, OD

  • Optometrist
  • Torrance, CA
National Provider Identifier
1366967796
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33679 Issued in CA
Practice address
1000 W Carson St # 6
Torrance, CA 90502-2004
Phone
(310) 222-2733
NPI assigned
Aug 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT33679 CA Primary

Addresses

Primary practice location

1000 W Carson St # 6
Torrance, CA 90502-2004

Mailing address

2641 Kempton Dr
Los Alamitos, CA 90720-4615
Phone (562) 493-0521

Other practice location 1

22015 Avalon Blvd Ste A
Carson, CA 90745-3355
Phone (310) 830-7584

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
I20210817003810 CA Practitioner - Optometry 7113277492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33679CAMDGeneral Practice Dentistry
OPT33679CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael a. Kapamajian, MD, Inc CurrentSince Jul 1, 2021 Accepting new patients
Yuan Optometry, a Professional Corporation PastSince Jul 17, 2021 Accepting new patients
Gerry Gee, Optometry Optometrist PastSince Mar 28, 2021 Accepting new patients

Locations

15141 Whittier Blvd
Ste 480
Whittier, CA 90603
Phone (562) 698-3776

Organizations & group practices 3

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": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366967796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 KEMPTON DR",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907204615",
            "telephone_number": "562-493-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST # 6",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-2733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22015 Avalon Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Carson",
            "state": "CA",
            "postal_code": "907453355",
            "country_code": "US",
            "telephone_number": "310-830-7584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIO",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.