NPIMap

Organization Active NPI

Allen Chung OD Optometric Corporation

  • Optometrist
  • San Diego, CA
National Provider Identifier
1427695550
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ALLEN CHUNG OD OPTOMETRIC CORPORATION
Practice address
9460 Mira Mesa Blvd Ste a
San Diego, CA 92126-4870
Phone
(858) 566-1756
NPI assigned
Dec 9, 2019
Last updated
Aug 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Authorized official

Name
Dr. Allen Chung, O.D.NPI 1003301391
Title
President
Phone
(858) 566-1756

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

9460 Mira Mesa Blvd Ste a
San Diego, CA 92126-4870

Mailing address

9460 Mira Mesa Blvd Ste a
San Diego, CA 92126-4870
Phone (858) 566-1756

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200228001301 CA Part B Supplier - Clinic/Group Practice 2365879574 Receives reassigned benefits from 5 practitioners
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1427695550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9460 MIRA MESA BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264870",
            "telephone_number": "858-566-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 MIRA MESA BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264870",
            "telephone_number": "858-566-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN CHUNG OD OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-09",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-566-1756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.