Organization Active NPI

Judy C. Liao O.D. Inc

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1689854028
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 11694T Issued in CA
Legal business name
JUDY C. LIAO O.D. INC
Practice address
631 N Broadway
Los Angeles, CA 90012-2801
Phone
(213) 680-0404
NPI assigned
Nov 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Dr. Judy C. Liao, O.D.
Title
Optometrist/Owner
Phone
(213) 680-0404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT 11694T CA Primary

Addresses

Primary practice location

631 N Broadway
Los Angeles, CA 90012-2801

Mailing address

631 N Broadway
Los Angeles, CA 90012-2801
Phone (213) 680-0404

Other identifiers 1

IdentifierTypeStateIssuer
SD0116940MedicaidCA

Other names 1

  • L.A. VISION OPTOMETRY Doing business as

National Provider Directory

National Provider Directory

Locations

311 S Broadway
Los Angeles, CA 90013
Phone (213) 680-0404

631 N Broadway
Los Angeles, CA 90012
Phone (213) 680-0404

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1689854028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122801",
            "telephone_number": "213-680-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122801",
            "telephone_number": "213-680-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDY C. LIAO O.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "LIAO",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "213-680-0404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 11694T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0116940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "L.A. VISION OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.