Park L Hsieh O D a Professional Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 12680 T Issued in CA

Legal business name

PARK L HSIEH O D A PROFESSIONAL OPTOMETRIC CORPORATION

Practice address

2704 Pinole Valley Rd
Pinole, CA 94564-1425

Phone

(510) 222-6567

Fax

(510) 222-2161

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Park Lee Hsieh, O.D.NPI 1730239559

Title

President

Phone

(510) 222-6567

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eye Love Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 4

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

• Park Lee Hsieh, O.D.

  • Optometrist
  • Pinole, CA
  • NPI 1730239559
  Medicare reassignment NPD Authorized official
• Gaganjot K Sidhu, OD

  • Optometrist
  • San Pablo, CA
  • NPI 1578265468
  Medicare reassignment NPD
• Kiumars Ajdari, O.D.

  • Optometrist
  • El Sobrante, CA
  • NPI 1396804746
  NPD (past)
• Nedda Shakib Misherghi, O.D.

  • Optometrist
  • Union City, CA
  • NPI 1043375447
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1487864815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 PINOLE VALLEY RD",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641425",
            "telephone_number": "510-222-6567",
            "fax_number": "510-222-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 PINOLE VALLEY RD",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641425",
            "telephone_number": "510-222-6567",
            "fax_number": "510-222-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK L HSIEH O D A PROFESSIONAL OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "HSIEH",
        "authorized_official_first_name": "PARK",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-222-6567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 12680 T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DP0855",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4475038",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Love Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Love Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Edward Oliva, OTD
• Douglas Edward Oliver, DDS
• Perris Jordan Oneil
• Mojdeh Oshagh, DDS
• Karin Pal
• Desttany R Parker
• Diana Althea Partovi
• Toral Kuntal Patel, DDS
• Adriana Patricia Perea
• Angeline Perez

• Optometrist in Pinole, CA
• Providers in Pinole, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.