Stephen R. Keller, O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT10085T Issued in CA

Legal business name

STEPHEN R. KELLER, O.D., INC.

Practice address

9596 Baseline Rd
Rancho Cucamonga, CA 91701-5034

Phone

(909) 989-1791

Fax

(909) 989-0782

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Robert Keller, O.D.

Title

President

Phone

(909) 989-1791

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alta Loma Optometric Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

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

• Jessica Michael Tadros, O.D.

  • Optometrist
  • Menifee, CA
  • NPI 1295165785
  Medicare reassignment NPD
• Nancy Suk-Ying Kwan, O.D.

  • Optometrist
  • Rancho Cucamonga, CA
  • NPI 1922187855
  NPD
• Michael Kevin Morton, O.D.

  • Optometrist
  • San Bernardino, CA
  • NPI 1720242258
  NPD
• Brian R Yap, O.D.

  • Optometrist
  • Los Angeles, CA
  • NPI 1164685194
  NPD
• Tracy Wong, O.D.

  • Optometrist
  • El Segundo, CA
  • NPI 1821177239
  NPD (past)
• Yu-Ho Cheng, O.D.

  • Optometrist
  • New York, NY
  • NPI 1952566960
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1619019197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9596 BASELINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015034",
            "telephone_number": "909-989-1791",
            "fax_number": "909-989-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9596 BASELINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015034",
            "telephone_number": "909-989-1791",
            "fax_number": "909-989-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN R. KELLER, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-989-1791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT10085T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD003130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alta Loma Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maxine Langdon Starr
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• Nicholle Stepanian, M.A.
• Stepping Stones to Healing
• Deborah Sterling, LCSW
• Steve Wysocki, PH.D., PC Dba Alta Loma Psychological Assoc
• Steven H Troyer
• Brandi Christina Stevens

• Optometrist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.