Individual provider Active NPI

Larissa Murakami, OD

  • Optometrist
  • Rancho Cucamonga, CA
National Provider Identifier
1497775266
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11186T Issued in CA
Practice address
12759 Foothill Blvd Ste C
Rancho Cucamonga, CA 91739-9336
Phone
(909) 899-0026
Fax
(909) 899-6381
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11186T CA Primary

Addresses

Primary practice location

12759 Foothill Blvd Ste C
Rancho Cucamonga, CA 91739-9336

Mailing address

12759 Foothill Blvd Ste C
Rancho Cucamonga, CA 91739-9336
Phone (909) 899-0026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11186TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Justin T Abo O D a Professional Corporation Optometrist CurrentSince May 12, 2007 Accepting new patients
Justin T. Abo, O.D. Optometrist Past Accepting new patients

Locations

12759 Foothill Blvd
Ste D
Rch Cucamonga, CA 91739
Phone (909) 899-0026

12759 Foothill Blvd
Ste C
Rch Cucamonga, CA 91739
Phone (909) 899-0026

Organizations & group practices 2

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1497775266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12759 FOOTHILL BLVD STE C",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399336",
            "telephone_number": "909-899-0026",
            "fax_number": "909-899-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12759 FOOTHILL BLVD STE C",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399336",
            "telephone_number": "909-899-0026",
            "fax_number": "909-899-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURAKAMI",
        "first_name": "LARISSA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11186T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.