Active NPI
Gary Kazumi Oda, O.D.
- Optometrist
- Martinez, CA
National Provider Identifier
1518017185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4752T
- Practice address
- 200 Muir Rd
Martinez, CA 94553-4614 - Phone
- (925) 372-1902
- Fax
- (925) 229-7550
- NPI assigned
- Jan 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4752T | CA | Primary |
Addresses
Primary practice location
200 Muir Rd
Martinez, CA 94553-4614
Mailing address
200 Muir Rd
Martinez, CA 94553-4614
Phone (925) 372-1026
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| X549533 | Other | CA | KAISER NATIONAL ID # |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4752T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1518017185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MUIR RD",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945534614",
"telephone_number": "925-372-1026",
"fax_number": "925-229-7550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MUIR RD",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945534614",
"telephone_number": "925-372-1902",
"fax_number": "925-229-7550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODA",
"first_name": "GARY",
"middle_name": "KAZUMI",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "4752T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER NATIONAL ID #",
"identifier": "X549533",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.