Jackson K Lau OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JACKSON K LAU OD INC

Practice address

435 N Roxbury Dr Ste 310
Beverly Hills, CA 90210-5005

Phone

(310) 570-2508

NPI assigned

Jul 16, 2021

Last updated

Apr 12, 2023By 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. Jackson Lau, ODNPI 1306903067

Title

President

Phone

(310) 570-2508

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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.

• Jackson Lau, O.D.

  • Pediatric Optometrist
  • Beverly Hills, CA
  • NPI 1306903067
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1376115501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 N ROXBURY DR STE 310",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105005",
            "telephone_number": "310-570-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N ROXBURY DR STE 310",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105005",
            "telephone_number": "310-570-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON K LAU OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-16",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-570-2508",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Harmony LLC
• J Timothy Katzen MD a Professional Corporation
• Michael Jablon, RMST
• Jack Ditlove, MD
• Brian Paul Jacks, MD
• Ashton Raiden Jackson, MD
• Greg Jackson, PPS
• Kirsten L Jackson
• Ollie Joseph Jackson III, M.D.
• Saphia Jackson

• Optometrist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.