Individual provider Active NPI

Anna Liew, OD

  • Optometrist
  • El Segundo, CA
National Provider Identifier
1417472960
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008736 Issued in NY
Practice address
483 N Aviation Blvd
El Segundo, CA 90245-2808
Phone
(310) 653-2873
NPI assigned
Aug 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 008736 NY Primary

Addresses

Primary practice location

483 N Aviation Blvd
El Segundo, CA 90245-2808

Mailing address

483 N Aviation Blvd
El Segundo, CA 90245-2808
Phone (310) 653-2873

Other practice location 1

Mail Code 112/ Desk 100 215 North Main
White River Junction, VT 05009-0001
Phone (802) 295-9363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
008736NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1501977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1417472960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 N AVIATION BLVD",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808",
            "telephone_number": "310-653-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 N AVIATION BLVD",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808",
            "telephone_number": "310-653-2873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mail Code 112/ Desk 100 215 North Main",
            "address_purpose": "LOCATION",
            "city": "White River Junction",
            "state": "VT",
            "postal_code": "050090001",
            "country_code": "US",
            "telephone_number": "802-295-9363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEW",
        "first_name": "ANNA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-06",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.