Active NPI
Paul Byoungjae Yoo, O.D
- Optometrist
- Anaheim, CA
National Provider Identifier
1417934316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT-110408LTG
- Practice address
- 1150 N Harbor Blvd
Suite 118
Anaheim, CA 92801-2400 - Phone
- (714) 758-0185
- Fax
- (714) 758-0759
- NPI assigned
- Dec 30, 2005
- Last updated
- Oct 20, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT-110408LTG | CA | Primary |
| Optometrist | 152W00000X | OPT11408T | CA |
Addresses
Primary practice location
1150 N Harbor Blvd
Suite 118
Anaheim, CA 92801-2400
Mailing address
1150 N. Harbor Blvd
Suite 118
Anaheim, CA 92801-2400
Phone (714) 758-0185
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT-110408LTG | CA | MD | Optometrist |
| OPT11408T | CA | MD | Optometrist |
| 11408 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carmen Jan Yoo, OD a Professional Corporation | Optometrist | Past | Accepting new patients |
| Equinox Home Care, Inc. | Past | Accepting new patients | |
| Vision Plus Medical Group | Past | Accepting new patients | |
| Carmen Jan Yoo | Optometrist | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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dba Fullerton Eyes Optometry
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- Fullerton, CA
- NPI 1063518181
-
- Durable Medical Equipment & Medical Supplies
- Newport Beach, CA
- NPI 1154955698
-
- Ophthalmology Physician
- Anaheim, CA
- NPI 1467634543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287532800000",
"number": "1417934316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 N. HARBOR BLVD",
"address_2": "SUITE 118",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928012400",
"telephone_number": "714-758-0185",
"fax_number": "714-758-0759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 N HARBOR BLVD",
"address_2": "SUITE 118",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928012400",
"telephone_number": "714-758-0185",
"fax_number": "714-758-0759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "PAUL",
"middle_name": "BYOUNGJAE",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-30",
"last_updated": "2010-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT-110408LTG",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT11408T",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.