Kenneth Atsuo Fukuda, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

11134T Issued in CA

Practice address

6270 Irvine Blvd
Irvine, CA 92620-2103

Phone

(949) 786-0143

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Woodbury Family Optometry

  • Clinic/Center
  • Irvine, CA
  • NPI 1194020347
  NPD (past) Authorized official

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1497764864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 NIGHTINGALE AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087234",
            "telephone_number": "714-403-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6270 IRVINE BLVD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202103",
            "telephone_number": "949-786-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUDA",
        "first_name": "KENNETH",
        "middle_name": "ATSUO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11134T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Li Fu, L.AC., PH.D.
• Fuentes Marriage and Family Therapy Practices, Inc.
• Alondra Fuentes
• Linda Asucena Fuentes
• Ruth Fuentes
• Kengo Fukunaga
• Fulgent Therapeutics LLC
• Full Spectrum Diagnostics
• Fuller Smiles Irvine Inc
• Julie M Fuller, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.