Lisa Fan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

15246 Issued in CA

Practice address

1701 Lundy Ave
Suite #120
San Jose, CA 95131-1832

Phone

(408) 453-9988

NPI assigned

Jul 1, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1437532090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 LUNDY AVE",
            "address_2": "SUITE #120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 LUNDY AVE",
            "address_2": "SUITE #120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311832",
            "telephone_number": "408-453-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "LISA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Practice Medical Associates, Inc.
• Familycare Behavioral Services (FamilyCare Autism Services)
• Foroozan Famoori, MD
• Debbi K. Fan, O.D.
• Gavin George Fan, M.D.
• Nancy Fan, RD
• Vincent C Fan, MD, MBA, MA, FAAO
• Wen Fan, M.A.
• Wen S Fan, DMD, MD
• Yu-Ying Fan, L.AC.

• Optometrist in San Jose, CA
• Providers in San Jose, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.