Professional Visioncare of West Hollywood, Inc a Professional Optom

Primary specialty

OptometristTaxonomy code 152W00000X

License

9103T Issued in CA

Legal business name

PROFESSIONAL VISIONCARE OF WEST HOLLYWOOD, INC A PROFESSIONAL OPTOM

Practice address

8210 Santa Monica Blvd
West Hollywood, CA 90046-5913

Phone

(323) 656-9550

Fax

(323) 650-2490

NPI assigned

Mar 4, 2009

Organization subpart

No

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

Authorized official

Name

Jimmy Cheng, O.D.NPI 1174663033

Title

Owner

Phone

(323) 656-9550

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Jimmy Robert Cheng, O.D.

  • Optometrist
  • West Hollywood, CA
  • NPI 1174663033
  Medicare reassignment Authorized official
• Kelly Tang

  • Optometrist
  • South Pasadena, CA
  • NPI 1629700125
  NPD (past)

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1609016559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465913",
            "telephone_number": "323-656-9550",
            "fax_number": "323-650-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8210 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465913",
            "telephone_number": "323-656-9550",
            "fax_number": "323-650-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL VISIONCARE OF WEST HOLLYWOOD, INC A PROFESSIONAL OPTOM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-04",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "CHENG",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-656-9550",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9103T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.