Individual provider Active NPI

Tracy Carol Kawamura, OD

  • Optometrist
  • Manhattan Beach, CA
National Provider Identifier
1679556872
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9750TPA Issued in CA
Practice address
3500 N Sepulveda Blvd
Suite E4
Manhattan Beach, CA 90266-3638
Phone
(310) 546-5568
Fax
(310) 546-5421
NPI assigned
Nov 22, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9750TPA CA Primary

Addresses

Primary practice location

3500 N Sepulveda Blvd
Suite E4
Manhattan Beach, CA 90266-3638

Mailing address

3200 N Sepulveda Blvd
Ste E4
Manhattan Beach, CA 90266-2469
Phone (310) 939-9926

Other identifiers 1

IdentifierTypeStateIssuer
SD0097500MedicaidCA

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
I20101021000541 CA Practitioner - Optometry 4183817273 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9750TPACAMDOptometrist
9750CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Howard E Stein OD an Optometric Corp Optometrist Current Accepting new patients
Golden Ardaya & Lin Optometry Inc Optometrist CurrentSince Oct 22, 2023 Accepting new patients
Sheldon M. Golden OD Optometric Corporation Optometrist Past Accepting new patients

Locations

201 E Magnolia Blvd
Ste 261
Burbank, CA 91502
Phone (818) 841-2393

3200 N Sepulveda Blvd
Ste E4
Manhattan Beach, CA 90266
Phone (310) 546-5568

11245 Washington Blvd
Whittier, CA 90606
Phone (562) 692-1208

Organizations & group practices 3

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679556872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 N SEPULVEDA BLVD",
            "address_2": "STE E4",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662469",
            "telephone_number": "310-939-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 N SEPULVEDA BLVD",
            "address_2": "SUITE E4",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663638",
            "telephone_number": "310-546-5568",
            "fax_number": "310-546-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWAMURA",
        "first_name": "TRACY",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2026-07-13",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9750TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0097500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

Verify at the official NPI Registry.