Individual provider Active NPI

Catherine Lam, OD

  • Optometrist
  • Culver City, CA
National Provider Identifier
1467123521
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34999 Issued in CA
Practice address
10814 Jefferson Blvd Ste F
Culver City, CA 90230-4988
Phone
(424) 453-2321
NPI assigned
Sep 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34999 CA Primary

Addresses

Primary practice location

10814 Jefferson Blvd Ste F
Culver City, CA 90230-4988

Mailing address

10814 Jefferson Blvd Ste F
Culver City, CA 90230-4988
Phone (424) 453-2321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225003133 CA Practitioner - Optometry 8820518533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tedder Optometry Group PCGroup PAC ID 9638600182, 3 clinicians

Practice addresses (Care Compare)

939 W Arrow Hwy
San Dimas, CA 91773-2410
Phone (909) 686-5402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34999CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Tedder Optometry Group, PC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Visionary Retail Management Ca, Inc CurrentSince Mar 20, 2025 Accepting new patients
Visionary Retail Management Ca, Inc PastSince Mar 20, 2025 Accepting new patients
Tedder Optometric Clinic Management, P.C. Optometrist PastSince Mar 12, 2023 Accepting new patients

Locations

10814 Jefferson Blvd
Ste F
Culver City, CA 90230
Phone (424) 453-2321

530 New Los Angeles Ave
Ste 115269
Moorpark, CA 93021
Phone (805) 624-1255

939 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 279-2472

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1467123521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10814 JEFFERSON BLVD STE F",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304988",
            "telephone_number": "424-453-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10814 JEFFERSON BLVD STE F",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304988",
            "telephone_number": "424-453-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "CATHERINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.