Organization Active NPI

Riviera Village Optometry PC

  • Optometrist
  • Redondo Beach, CA
National Provider Identifier
1457537946
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RIVIERA VILLAGE OPTOMETRY PC
Practice address
239 Avenida del Norte
Redondo Beach, CA 90277-5702
Phone
(310) 540-5545
Fax
(310) 540-5536
NPI assigned
Jan 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Authorized official

Name
Dr. Lynn Oku, O.D.NPI 1386614360
Title
Optometrist
Phone
(310) 540-5545

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

239 Avenida del Norte
Redondo Beach, CA 90277-5702

Mailing address

239 Avenida del Norte
Redondo Beach, CA 90277-5702
Phone (310) 540-5545

Other names 1

  • Mark Hilker Williams Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120611000494 CA Part B Supplier - Clinic/Group Practice 4880855378 Receives reassigned benefits from 2 practitioners
Practice locations: Redondo Beach, CA

National Provider Directory

National Provider Directory

Locations

9001 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 275-1646

239 Avenida del Norte
Redondo Beach, CA 90277
Phone (310) 540-5545

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1457537946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 AVENIDA DEL NORTE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775702",
            "telephone_number": "310-540-5545",
            "fax_number": "310-540-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 AVENIDA DEL NORTE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775702",
            "telephone_number": "310-540-5545",
            "fax_number": "310-540-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVIERA VILLAGE OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "OKU",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "310-540-5545",
        "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": [
        {
            "organization_name": "Mark Hilker Williams",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.