Vistapark Family Optometry PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

10154T Issued in CA

Legal business name

VISTAPARK FAMILY OPTOMETRY PC

Practice address

428 W Capitol Expy
San Jose, CA 95136-1303

Phone

(408) 578-6181

Fax

(408) 578-0617

NPI assigned

Jan 9, 2017

Organization subpart

No

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

Authorized official

Name

Yun Sang Park, O.D.

Title

Ceo

Phone

(408) 578-6181

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1508302944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 W CAPITOL EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951361303",
            "telephone_number": "408-578-6181",
            "fax_number": "408-578-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 W CAPITOL EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951361303",
            "telephone_number": "408-578-6181",
            "fax_number": "408-578-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTAPARK FAMILY OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "YUN",
        "authorized_official_middle_name": "SANG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-578-6181",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10154T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.