Active NPI
Esther Lee Ahn, O.D.
- Optometrist
- Cerritos, CA
National Provider Identifier
1477542678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11854T
- Practice address
- 11900 South St
Ste 121
Cerritos, CA 90703-6847 - Phone
- (562) 809-4041
- Fax
- (562) 809-5142
- NPI assigned
- Oct 19, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11854T | CA | Primary |
Addresses
Primary practice location
11900 South St
Ste 121
Cerritos, CA 90703-6847
Mailing address
11900 South St
Ste 121
Cerritos, CA 90703-6847
Phone (562) 809-4041
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0118540 | Medicaid | CA |
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 |
|---|---|---|---|
| 128139 | CA | MD | Marriage & Family Therapist |
| 11854T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477542678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11900 SOUTH ST",
"address_2": "STE 121",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907036847",
"telephone_number": "562-809-4041",
"fax_number": "562-809-5142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11900 SOUTH ST",
"address_2": "STE 121",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907036847",
"telephone_number": "562-809-4041",
"fax_number": "562-809-5142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHN",
"first_name": "ESTHER",
"middle_name": "LEE",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11854T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0118540",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.