NPIMap

Organization Active NPI

Jonathan Chan O.D. Inc

  • Optometrist
  • Corona, CA
National Provider Identifier
1386286193
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JONATHAN CHAN O.D. INC
Practice address
2615 Tuscany St
Corona, CA 92881
Phone
(951) 268-3036
NPI assigned
Oct 14, 2019
Last updated
Oct 14, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Authorized official

Name
Dr. Jonathan Chan, ODNPI 1093123721
Title
President
Phone
(562) 537-8687

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2615 Tuscany St
Corona, CA 92881

Mailing address

1845 Majestic Dr
Corona, CA 92880

National Provider Directory

National Provider Directory

Locations

2615 Tuscany St
Corona, CA 92881
Phone (951) 268-3036

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1386286193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 MAJESTIC DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 TUSCANY ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92881",
            "telephone_number": "951-268-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN CHAN O.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-537-8687",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.