Individual provider Active NPI

Thear Bun

  • Optometrist
  • West Covina, CA
National Provider Identifier
1487082319
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14791 Issued in CA
Practice address
1000 Lakes Dr Ste 180
West Covina, CA 91790-2927
Phone
(626) 919-4821
Fax
(626) 917-8439
NPI assigned
Nov 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14791 CA Primary

Addresses

Primary practice location

1000 Lakes Dr Ste 180
West Covina, CA 91790-2927

Mailing address

1000 Lakes Dr Ste 180
West Covina, CA 91790-2927
Phone (626) 919-4821

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
I20140512000584 CA Practitioner - Optometry 1557594868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Western University of Health Sciences College of Dental Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael Morris OD a Professional CorporationGroup PAC ID 9739135088, 2 clinicians

Practice addresses (Care Compare)

631 N Azusa Ave
Azusa, CA 91702-2910
Phone (626) 919-4821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1487082319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LAKES DR STE 180",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902927",
            "telephone_number": "626-919-4821",
            "fax_number": "626-917-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAKES DR STE 180",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902927",
            "telephone_number": "626-919-4821",
            "fax_number": "626-917-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUN",
        "first_name": "THEAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.