C K Chan OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT6179TLG Issued in CA

Legal business name

C K CHAN OD INC

Practice address

537 S Atlantic Blvd
Monterey Park, CA 91754-3815

Phone

(626) 281-5856

Fax

(626) 281-3389

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Chiu K Chan, O.D.

Title

President

Phone

(626) 281-5856

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1609924299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 S ATLANTIC BLVD",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917543815",
            "telephone_number": "626-281-5856",
            "fax_number": "626-281-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 S ATLANTIC BLVD",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917543815",
            "telephone_number": "626-281-5856",
            "fax_number": "626-281-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C K CHAN OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "CHIU",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-281-5856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT6179TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0061790",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0061791",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian William Burney, CRNA
• Angel R Bustamante, PA-C
• BW Occupational Therapy Professional Corporation
• Byran Chen DDS, Inc
• C D Healthcare Inc
• C. George Lai, M.D., Inc.
• Beatriz Cabico-Bausley, RN
• California Cancer Institute a Medical Corporation
• California Care Medical Group LLC
• Natalia Calixto

• Optometrist in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.