Wang Optometric Associates Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT8032TPA Issued in CA

Legal business name

WANG OPTOMETRIC ASSOCIATES INC.

Practice address

15908 Bear Valley Rd
Suite a
Victorville, CA 92395-9547

Phone

(760) 243-4559

Fax

(760) 243-2052

NPI assigned

Dec 9, 2010

Organization subpart

No

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

Authorized official

Name

Cheng Yu Wang, ODNPI 1881996692

Title

President

Phone

(951) 422-2381

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

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

• Cheng Yu Wang, O.D.

  • Optometrist
  • Victorville, CA
  • NPI 1881996692
  Medicare reassignment NPD Authorized official
• Stephen M Dean, O.D.

  • Optometrist
  • San Bernardino, CA
  • NPI 1043376528
  Medicare reassignment NPD
• Li Jung Wang, O.D.

  • Optometrist
  • Ontario, CA
  • NPI 1235444605
  Medicare reassignment NPD

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520985600000",
    "number": "1609179803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15908 BEAR VALLEY RD",
            "address_2": "SUITE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923959547",
            "telephone_number": "760-243-4559",
            "fax_number": "760-243-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15908 BEAR VALLEY RD",
            "address_2": "SUITE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923959547",
            "telephone_number": "760-243-4559",
            "fax_number": "760-243-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANG OPTOMETRIC ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2018-03-14",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "CHENG YU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-422-2381",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8032TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0080320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "EV797A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc. (Walmart Pharmacy 10-1588)
• Walmart Inc. (Walmart Pharmacy 10-4392)
• Katie Walsh
• Leticia Walsh
• Markes Walton
• Ai-Jen Wang, M.D.
• Cheng Yu Wang, O.D.
• Dawei Wang, D.O
• Li Miao Wang, PA-C
• Yu Lan Wang, LAC

• Optometrist in Victorville, CA
• Providers in Victorville, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.