Organization Active NPI

Crystal Clear Vision Center

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1386635266
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
09873T Issued in CA
Legal business name
CRYSTAL CLEAR VISION CENTER
Practice address
781 Vallejo St
San Francisco, CA 94133-3834
Phone
(415) 677-9930
Fax
(415) 677-9599
NPI assigned
Oct 31, 2005
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Theresa Chew, O.D.NPI 1265423131
Title
Optometrist Owner
Phone
(415) 677-9930

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 09873T CA Primary

Addresses

Primary practice location

781 Vallejo St
San Francisco, CA 94133-3834

Mailing address

781 Vallejo St
San Francisco, CA 94133-3834
Phone (415) 677-9930

Other identifiers 1

IdentifierTypeStateIssuer
GSD004530MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1386635266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 VALLEJO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333834",
            "telephone_number": "415-677-9930",
            "fax_number": "415-677-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 VALLEJO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333834",
            "telephone_number": "415-677-9930",
            "fax_number": "415-677-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CLEAR VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "CHEW",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER",
        "authorized_official_telephone_number": "415-677-9930",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "09873T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.