Active NPI
Ian Charles Gao, OD
- Optometrist
- Citrus Heights, CA
National Provider Identifier
1679336192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 35633
- Practice address
- 5899 Sunrise Blvd
Citrus Heights, CA 95610-6866 - Phone
- (916) 534-1018
- NPI assigned
- Feb 6, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 | 35633 | CA | Primary |
Addresses
Primary practice location
5899 Sunrise Blvd
Citrus Heights, CA 95610-6866
Mailing address
511 Bishop Dr
La Habra, CA 90631-3004
Phone (562) 713-0138
Other names 1
- Dr. Ian Charles Gao
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35633 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1679336192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 BISHOP DR",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906313004",
"telephone_number": "562-713-0138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5899 SUNRISE BLVD",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956106866",
"telephone_number": "916-534-1018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAO",
"first_name": "IAN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-06",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "35633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "IAN",
"last_name": "GAO",
"middle_name": "CHARLES",
"prefix": "DR.",
"credential": "OD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Citrus Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.