Tedder Optometric Corporation, PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TEDDER OPTOMETRIC CORPORATION, PC

Practice address

23625 El Toro Rd Ste E
Lake Forest, CA 92630-4728

Phone

(949) 227-2524

Fax

(949) 446-6591

NPI assigned

May 2, 2023

Organization subpart

No

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

Authorized official

Name

Dolsie McDonald

Title

Manager

Phone

(726) 444-4078

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Hansra Optometric Corporation

  • Eyewear Supplier
  • Sacramento, CA
  • NPI 1366258436

  O20230711003128

  Same enrollment

Tax ID family

Hansra Optometric Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hansra Optometric Corporation

  • Eyewear Supplier
  • Sacramento, CA
  • NPI 1366258436
  NPD tax ID

Locations

Practitioners 33

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

• Liyan Arasteh, OD

  • Optometrist
  • Irvine, CA
  • NPI 1629656095
  Medicare reassignment NPD
• Caroline Yargo Basta, OD

  • Optometrist
  • Sacramento, CA
  • NPI 1477336329
  Medicare reassignment NPD
• Martha Denise Burnett, O.D.

  • Optometrist
  • Elk Grove, CA
  • NPI 1851477731
  Medicare reassignment NPD
• Andrew Hongkun Chen, OD

  • Optometrist
  • Davis, CA
  • NPI 1558183897
  Medicare reassignment NPD
• Alast Eisa

  • Optometrist
  • Rancho Santa Margarita, CA
  • NPI 1174243133
  Medicare reassignment NPD
• Shelby Shania Esambolchi, OD

  • Optometrist
  • San Diego, CA
  • NPI 1457931859
  Medicare reassignment NPD
• Susan Ghodsi, O.D.

  • Optometrist
  • Irvine, CA
  • NPI 1568665842
  Medicare reassignment NPD
• Sandeep Kaur Gill, OD

  • Optometrist
  • Sacramento, CA
  • NPI 1467911347
  Medicare reassignment NPD
• Dilini T Hemachandra, O.D.

  • Optometrist
  • Folsom, CA
  • NPI 1932883519
  Medicare reassignment NPD
• Cemone Khan, O.D.

  • Optometrist
  • La Palma, CA
  • NPI 1275076721
  Medicare reassignment NPD
• Angela J Kwak, O.D.

  • Optometrist
  • Anaheim, CA
  • NPI 1255564860
  Medicare reassignment NPD
• Cindy Si Lam, OD

  • Optometrist
  • Sacramento, CA
  • NPI 1487266920
  Medicare reassignment NPD

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1679262158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19100 RIDGEWOOD PKWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782591834",
            "telephone_number": "726-444-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23625 EL TORO RD STE E",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304728",
            "telephone_number": "949-227-2524",
            "fax_number": "949-446-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEDDER OPTOMETRIC CORPORATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "DOLSIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "726-444-4078"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lin Tao
• Jesse Ray Tarin, LVN
• Nicholas Tauaese, DC
• Daniel C Taylor, DPT
• Kyra Teat
• Maria Cristina Salak Teofilo
• Katherine Terhardt
• Darren Terry, D.P.T.
• Fabiola Testa
• Nadia Teymoorian, PSY.D

• Optometrist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.