Individual provider Active NPI

Paulina T.Q. Han, OD

  • Optometrist
  • Temple City, CA
National Provider Identifier
1558382002
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 11057 TPA Issued in CA
Practice address
5803 Rosemead Blvd
Temple City, CA 91780-1833
Phone
(626) 287-8505
Fax
(626) 287-2645
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 11057 TPA CA Primary

Addresses

Primary practice location

5803 Rosemead Blvd
Temple City, CA 91780-1833

Mailing address

5803 Rosemead Blvd
Temple City, CA 91780-1833
Phone (626) 287-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091208000117 CA Practitioner - Optometry 0840339677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5803 Rosemead Blvd
Temple City, CA 91780-1833
Phone (626) 287-8505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 11057 TPACAMDOptometrist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1376265600000",
    "number": "1558382002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 ROSEMEAD BLVD",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917801833",
            "telephone_number": "626-287-8505",
            "fax_number": "626-287-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 ROSEMEAD BLVD",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917801833",
            "telephone_number": "626-287-8505",
            "fax_number": "626-287-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "PAULINA",
        "middle_name": "T.Q.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 11057 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple City, CA

Sources for this page

Verify at the official NPI Registry.