Individual provider Active NPI

Jeremy Chin, O.D.

  • Optometrist
  • Los Gatos, CA
National Provider Identifier
1588046387
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15287 Issued in CA
Practice address
825 Pollard Rd
Suite 208
Los Gatos, CA 95032-1435
Phone
(408) 378-1701
NPI assigned
Jun 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15287 CA Primary

Addresses

Primary practice location

825 Pollard Rd
Suite 208
Los Gatos, CA 95032-1435

Mailing address

825 Pollard Rd
Suite 208
Los Gatos, CA 95032-1435
Phone (408) 378-1701

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1588046387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 POLLARD RD",
            "address_2": "SUITE 208",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321435",
            "telephone_number": "408-378-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 POLLARD RD",
            "address_2": "SUITE 208",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321435",
            "telephone_number": "408-378-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.