Organization Active NPI

Koharaeye, PC

  • Ophthalmology Physician
  • Culver City, CA
National Provider Identifier
1497262141
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
KOHARAEYE, PC
Practice address
3831 Hughes Ave Ste 104
Culver City, CA 90232-6834
Phone
(323) 682-0289
Fax
(855) 538-9401
NPI assigned
Jan 3, 2018
Last updated
Sep 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Authorized official

Name
Dr. Eunice Maya Kohara, DONPI 1386899631
Title
President
Phone
(323) 682-0289

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X NU

Addresses

Primary practice location

3831 Hughes Ave Ste 104
Culver City, CA 90232-6834

Mailing address

8605 Santa Monica Blvd # 69638
Los Angeles, CA 90069-4109
Phone (323) 682-0289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190814000295 CA Part B Supplier - Clinic/Group Practice 3870820830 Receives reassigned benefits from 1 practitioner
Practice locations: Culver City, CA

National Provider Directory

National Provider Directory

Locations

3831 Hughes Ave
Ste 104
Culver City, CA 90232
Phone (310) 837-9700

8605 Santa Monica Blvd
#69638
Los Angeles, CA 90069

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1497262141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 SANTA MONICA BLVD # 69638",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900694109",
            "telephone_number": "323-682-0289",
            "fax_number": "855-538-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 104",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326834",
            "telephone_number": "323-682-0289",
            "fax_number": "855-538-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOHARAEYE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "KOHARA",
        "authorized_official_first_name": "EUNICE",
        "authorized_official_middle_name": "MAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-682-0289",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.