Organization Active NPI

Eye People Optometry, Inc.

  • Optometrist
  • Montebello, CA
National Provider Identifier
1396259669
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15317TLG Issued in CA
Legal business name
EYE PEOPLE OPTOMETRY, INC.
Practice address
2156 Montebello Town Ctr
Montebello, CA 90640-2170
Phone
(323) 720-1600
NPI assigned
Nov 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Authorized official

Name
Jennifer Khem, OD
Title
Ceo
Phone
(424) 346-2845

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 15317TLG CA Primary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X 15317TLG CA
Pediatric OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WP0200X 15317TLG CA

Addresses

Primary practice location

2156 Montebello Town Ctr
Montebello, CA 90640-2170

Mailing address

2156 Montebello Town Ctr
Montebello, CA 90640-2170
Phone (323) 720-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190716002840 CA Part B Supplier - Clinic/Group Practice 6406181288 Receives reassigned benefits from 3 practitioners
Practice locations: Montebello, CA

National Provider Directory

National Provider Directory

Locations

2156 Montebello Town Ctr
Montebello, CA 90640
Phone (323) 720-1600

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1511568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1396259669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 MONTEBELLO TOWN CTR",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402170",
            "telephone_number": "323-720-1600",
            "fax_number": "323-278-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2156 MONTEBELLO TOWN CTR",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402170",
            "telephone_number": "323-720-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PEOPLE OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-25",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "KHEM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-346-2845",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15317TLG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "15317TLG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "15317TLG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.