East Bay Vision Center Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

CA 0085330T Issued in CA

Legal business name

EAST BAY VISION CENTER OPTOMETRY INC

Practice address

388 9TH St Ste 157
Oakland, CA 94607

Phone

(510) 268-9600

Fax

(510) 268-1608

NPI assigned

Jul 10, 2006

Last updated

Jul 18, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eileen Lo

Title

President

Phone

(510) 268-9600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• East Bay Vision Center Optometry Inc

  • Optometrist
  • Fremont, CA
  • NPI 1083743066

  O20050120000949

  Same enrollment

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• East Bay Vision Center Optometry Inc

  • Optometrist
  • Fremont, CA
  • NPI 1083743066
  NPPES parent name
• East Bay Vision Center Optometry Inc

  • Optometrist
  • Oakland, CA
  • NPI 1699814848
  NPPES parent name

Practitioners 5

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.

• Camellia Lee, OD

  • Optometrist
  • Oakland, CA
  • NPI 1518697838
  Medicare reassignment Care Compare group NPD
• Eileen S Lee, O.D.

  • Optometrist
  • Oakland, CA
  • NPI 1851355309
  Medicare reassignment Care Compare group NPD
• Rebecca Y Lee, O.D.

  • Optometrist
  • Oakland, CA
  • NPI 1841642295
  Medicare reassignment Care Compare group NPD
• Matthew Lee

  • Optometrist
  • Fremont, CA
  • NPI 1467128173
  Medicare reassignment NPD
• Xin Yuan Tian, OD

  • Optometrist
  • Dublin, CA
  • NPI 1255059630
  Medicare reassignment NPD

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1396779344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 9TH ST STE 157",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074290",
            "telephone_number": "510-268-9600",
            "fax_number": "510-268-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 9TH ST STE 157",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94607",
            "telephone_number": "510-268-9600",
            "fax_number": "510-268-1608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946123913",
            "country_code": "US",
            "telephone_number": "510-839-0938",
            "fax_number": "510-839-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST BAY VISION CENTER OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-268-9600"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "CA 0085330T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Bay Sleep Management
• East Bay Special Imaging
• East Bay Special Imaging Medical Group, Inc. (East Bay Special Imaging)
• East Bay Special Surgery LLC
• East Bay Vascular Medical Group
• East Bay Vision Center Optometry Inc
• East Bay Women's Health, Inc
• East Oakland Community Project
• East Oakland Obs GYN Med GP Inc
• East Oakland Pediatrics Inc

• Optometrist in Oakland, CA
• Providers in Oakland, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.