Individual provider Active NPI

Julie Yip, OD

  • Optometrist
  • West Covina, CA
National Provider Identifier
1477994085
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11990 Issued in CA
Practice address
420 S Leaf Ave
West Covina, CA 91791-2521
Phone
(323) 744-9788
NPI assigned
Jul 11, 2013
Last updated
Jul 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11990 CA Primary

Addresses

Primary practice location

420 S Leaf Ave
West Covina, CA 91791-2521

Mailing address

420 S Leaf Ave
West Covina, CA 91791-2521
Phone (323) 744-9788

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
I20160613002270 CA Practitioner - Optometry 3173814670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Larry J Gottlieb Inc a Professional Corporation Optometrist PastSince Apr 4, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1477994085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S LEAF AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912521",
            "telephone_number": "323-744-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S LEAF AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912521",
            "telephone_number": "323-744-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIP",
        "first_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.