Individual provider Active NPI

Katie W. Chu, O.D.

  • Optometrist
  • Rosemead, CA
National Provider Identifier
1689756629
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10605 T Issued in CA
Practice address
3106 San Gabriel Blvd
Unit H
Rosemead, CA 91770-2579
Phone
(626) 288-6278
Fax
(626) 571-1868
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 10605 T CA Primary

Addresses

Primary practice location

3106 San Gabriel Blvd
Unit H
Rosemead, CA 91770-2579

Mailing address

3106 San Gabriel Blvd
Unit H
Rosemead, CA 91770-2579
Phone (626) 288-6278

Other identifiers 2

IdentifierTypeStateIssuer
OP10605OtherCAOLD MEDICARE NUMBER
SD0106050MedicaidCA

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
I20060223000801 CA Practitioner - Optometry 3971519208 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10605 TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Katie W. Chu, O.D., Inc. Optometrist CurrentSince Jan 1, 2006 Accepting new patients

Locations

3106 San Gabriel Blvd
Ste H
Rosemead, CA 91770
Phone (310) 462-4806

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689756629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 SAN GABRIEL BLVD",
            "address_2": "UNIT H",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917702579",
            "telephone_number": "626-288-6278",
            "fax_number": "626-571-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 SAN GABRIEL BLVD",
            "address_2": "UNIT H",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917702579",
            "telephone_number": "626-288-6278",
            "fax_number": "626-571-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "KATIE",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10605 T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD MEDICARE NUMBER",
            "identifier": "OP10605",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemead, CA

Sources for this page

Verify at the official NPI Registry.