Active NPI
Kevin Tam, O.D.
- Optometrist
- Chula Vista, CA
National Provider Identifier
1386027407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 15925
- Practice address
- 2015 Birch Rd Ste 1019
Chula Vista, CA 91915-2011 - Phone
- (619) 397-0965
- NPI assigned
- Jul 7, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 15925 | CA | Primary |
Addresses
Primary practice location
2015 Birch Rd Ste 1019
Chula Vista, CA 91915-2011
Mailing address
14224 Bernabe CT
San Diego, CA 92129-3405
Phone (510) 918-9951
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Eyewear Supplier
- National City, CA
- NPI 1982758546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694649600000",
"number": "1386027407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14224 BERNABE CT",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921293405",
"telephone_number": "510-918-9951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 BIRCH RD STE 1019",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919152011",
"telephone_number": "619-397-0965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-07",
"last_updated": "2023-09-14",
"certification_date": "2023-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "15925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.