David Shin Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 12779T Issued in CA

Legal business name

DAVID SHIN OPTOMETRY

Doing business as

Crystal Vision Optometry

Practice address

8003 Archibald Ave
Rancho Cucamonga, CA 91730-2892

Phone

(909) 980-5552

Fax

(909) 568-2413

NPI assigned

May 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. David S Shin, OD

Title

Owner, OD

Phone

(909) 980-5552

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crystal Vision Optometry Doing business as

Locations

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1376778555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 ARCHIBALD AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917302892",
            "telephone_number": "909-980-5552",
            "fax_number": "909-568-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8003 ARCHIBALD AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917302892",
            "telephone_number": "909-980-5552",
            "fax_number": "909-568-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID SHIN OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER, OD",
        "authorized_official_telephone_number": "909-980-5552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 12779T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0127790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Vision Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raneem Darwich
• Christina Marie Dascenzi
• Alexandria Davalos
• Arianna Davalos
• David Castillo, DDS, Inc.
• Francis David, MS, CCC-SLP
• Carla Marie Davidson, LCSW
• Davis and Associates Consulting Services, Inc.
• Alexis Davis
• Angela Davis

• Optometrist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; 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.