Active NPI
Dennis K Kawabe, OD
- Optometrist
- Los Angeles, CA
National Provider Identifier
1649294976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 4849 TPA
- Practice address
- 4403 S Vermont Ave
Los Angeles, CA 90037-2413 - Phone
- (323) 232-1234
- Fax
- (323) 232-3789
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT 4849 TPA | CA | Primary |
Addresses
Primary practice location
4403 S Vermont Ave
Los Angeles, CA 90037-2413
Mailing address
691 Bataan PL
Monterey Park, CA 91755-4264
Phone (626) 280-5267
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48491 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 4849 TPA | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1649294976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "691 BATAAN PL",
"city": "MONTEREY PARK",
"state": "CA",
"postal_code": "917554264",
"telephone_number": "626-280-5267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4403 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900372413",
"telephone_number": "323-232-1234",
"fax_number": "323-232-3789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAWABE",
"first_name": "DENNIS",
"middle_name": "K",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 4849 TPA",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "48491",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.