Teruo Watanabe, O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5162T Issued in CA

Legal business name

TERUO WATANABE, O.D., INC.

Doing business as

PLAZA VISION OPTOMETRY

Practice address

525 S Myrtle Ave Ste 107
Monrovia, CA 91016-6139

Phone

(626) 359-3937

Fax

(626) 358-5030

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Teruo Watanabe, O.D.NPI 1952402026

Title

Optometrist/President

Phone

(626) 359-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PLAZA VISION OPTOMETRY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Teruo Watanabe, O.D.

  • Optometrist
  • Monrovia, CA
  • NPI 1952402026
  Medicare reassignment Care Compare group NPD Authorized official
• Alysa E. Watanabe, O.D.

  • Optometrist
  • Monrovia, CA
  • NPI 1467617175
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1407957582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S MYRTLE AVE STE 107",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910166139",
            "telephone_number": "626-359-3937",
            "fax_number": "626-358-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S MYRTLE AVE STE 107",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910166139",
            "telephone_number": "626-359-3937",
            "fax_number": "626-358-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERUO WATANABE, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "WATANABE",
        "authorized_official_first_name": "TERUO",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "626-359-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5162T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0056120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLAZA VISION OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Isabella Terry
• Jalen Terry
• Paige Terry
• Taranda Terry
• Nevada Teruel
• Elise Tervalon
• Adam Terzi
• Rebecca Jacqueline Terzian, M.A.
• Jessica Teselle
• Emebet Tesfaye

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.