Individual provider Active NPI

Daniel Cha, O.D.

  • Optometrist
  • Bonita, CA
National Provider Identifier
1386078020
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14779 Issued in CA
Practice address
4502 Bonita Rd
Bonita, CA 91902-1427
Phone
(619) 479-7334
Fax
(619) 475-3456
NPI assigned
Aug 29, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 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 14779 CA Primary

Addresses

Primary practice location

4502 Bonita Rd
Bonita, CA 91902-1427

Mailing address

4158 Decoro St
12
San Diego, CA 92122-1419
Phone (619) 916-1455

Other practice location 1

270 E Douglas Ave # 107B
El Cajon, CA 92020-4514
Phone (619) 916-1455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131113001149 CA Practitioner - Optometry 0042446460 Reassigns benefits to 1 organization
I20151228001567 CA Practitioner - Optometry 0042446460 Practice locations: Bonita, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paje Optometric a Professional Corporation Optometrist CurrentSince Jan 19, 2015 Accepting new patients
Hilton Manor, LLC Past Accepting new patients

Locations

2615 Grand Ave
Long Beach, CA 90815
Phone (562) 283-0502

1618 Laurel Ave
Redlands, CA 92373
Phone (909) 792-6050

8171 Magnolia Ave
Riverside, CA 92504
Phone (951) 657-3842

2414 S Fairview St
Ste 103
Santa Ana, CA 92704
Phone (714) 557-9442

240 Hospital Cir
Westminster, CA 92683
Phone (714) 892-6686

Organizations & group practices 2

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": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1386078020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4158 DECORO ST",
            "address_2": "12",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221419",
            "telephone_number": "619-916-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 BONITA RD",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919021427",
            "telephone_number": "619-479-7334",
            "fax_number": "619-475-3456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 E Douglas Ave # 107B",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920204514",
            "country_code": "US",
            "telephone_number": "619-916-1455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHA",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-29",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita, CA

Sources for this page

Verify at the official NPI Registry.