Individual provider Active NPI

Lucy Wun, O.DO

  • Optometrist
  • Cupertino, CA
National Provider Identifier
1659410819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11325T Issued in CA
Practice address
10525 S de Anza Blvd Ste 190
Cupertino, CA 95014-4448
Phone
(408) 725-1900
Fax
(408) 725-1989
NPI assigned
Feb 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11325T CA Primary

Addresses

Primary practice location

10525 S de Anza Blvd Ste 190
Cupertino, CA 95014-4448

Mailing address

10525 S de Anza Blvd Ste 190
Cupertino, CA 95014-4448
Phone (408) 725-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040728000823 CA Practitioner - Optometry 2163492034 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
134583CAMDClinical Social Worker
11325TCAMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659410819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 S DE ANZA BLVD STE 190",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950144448",
            "telephone_number": "408-725-1900",
            "fax_number": "408-725-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10525 S DE ANZA BLVD STE 190",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950144448",
            "telephone_number": "408-725-1900",
            "fax_number": "408-725-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUN",
        "first_name": "LUCY",
        "credential": "O.DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11325T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

Verify at the official NPI Registry.