Individual provider Active NPI

Christopher Young, OD

  • Optometrist
  • Alameda, CA
National Provider Identifier
1558441691
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10571 T Issued in CA
Practice address
847 Marina Village Pkwy
Alameda, CA 94501-1035
Phone
(510) 337-7970
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10571 T CA Primary

Addresses

Primary practice location

847 Marina Village Pkwy
Alameda, CA 94501-1035

Mailing address

847 Marina Village Pkwy
Alameda, CA 94501-1035

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
I20050914000729 CA Practitioner - Optometry 4880621564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10571 TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher P. Young OD, Inc. Optometrist CurrentSince Sep 14, 1999 Accepting new patients

Locations

847 Marina Village Pkwy
Alameda, CA 94501
Phone (408) 504-6053

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558441691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 MARINA VILLAGE PKWY",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 MARINA VILLAGE PKWY",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011035",
            "telephone_number": "510-337-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10571 T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

Verify at the official NPI Registry.