Matty Chang OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

12280T Issued in CA

Legal business name

MATTY CHANG OD INC

Doing business as

Century Eyecare Optometry

Practice address

630 N Rose Dr
Placentia, CA 92870-7513

Phone

(714) 524-6688

Fax

(714) 524-7678

NPI assigned

Aug 24, 2009

Last updated

Aug 31, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matty Chang, O.DNPI 1770502296

Title

Optometrist

Phone

(714) 524-6688

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Century Eyecare Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matty Chang, O.D.

  • Optometrist
  • Orange, CA
  • NPI 1770502296
  Medicare reassignment Authorized official
• Jerry T Lin, O.D.

  • Optometrist
  • Placentia, CA
  • NPI 1710022686
  NPD (past)

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1487887576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N ROSE DR",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928707513",
            "telephone_number": "714-524-6688",
            "fax_number": "714-524-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N ROSE DR",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928707513",
            "telephone_number": "714-524-6688",
            "fax_number": "714-524-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTY CHANG OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "MATTY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "714-524-6688",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12280T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0122800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Century Eyecare Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Elizabeth Martino, ADN
• Mary Regina Pham D.D.S., M.S. Dental Corporation (Lollipop Pediatric Dentistry)
• Holly Lynn Mason
• Mat Management, Inc.
• Lecole Matchem
• Julie Max, MED, ATC
• Judy Maximous
• Maximum DME Corporation
• Maxum Physical Therapy Inc
• Skylar Maxwell

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.