NPIMap

Organization Active NPI

Justin T. Abo, O.D.

  • Optometrist
  • Rancho Cucamonga, CA
National Provider Identifier
1508944711
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11100T Issued in CA
Legal business name
JUSTIN T. ABO, O.D.
Practice address
12759 Foothill Blvd
Suite D
Rancho Cucamonga, CA 91739-9336
Phone
(909) 899-0026
Fax
(909) 899-6381
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Justin T Abo, O.D.NPI 1952386963
Title
Optometrist
Phone
(909) 899-0026

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 11100T CA Primary

Addresses

Primary practice location

12759 Foothill Blvd
Suite D
Rancho Cucamonga, CA 91739-9336

Mailing address

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

Other names 1

  • FOOTHILL OPTOMETRIC CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508944711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12759 FOOTHILL BLVD",
            "address_2": "SUITE D",
            "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",
            "address_2": "SUITE D",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399336",
            "telephone_number": "909-899-0026",
            "fax_number": "909-899-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN T. ABO, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABO",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "909-899-0026",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11100T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOTHILL OPTOMETRIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.