Osamu Ikeda, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6054T Issued in CA

Practice address

8751 Valley View St
Buena Park, CA 90620-3566

Phone

(714) 827-7191

Fax

(714) 827-8191

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619901352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8751 VALLEY VIEW ST",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203566",
            "telephone_number": "714-827-7191",
            "fax_number": "714-827-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8751 VALLEY VIEW ST",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203566",
            "telephone_number": "714-827-7191",
            "fax_number": "714-827-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEDA",
        "first_name": "OSAMU",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6054T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Hwang, MSW
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• Marina Imanaka
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• Innovation Physical Therapy and Rehab Center, Inc.
• Innovative Behavior Interventions

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.