Organization Active NPI

Dr Luque OD, Apoc

  • Optometrist
  • Lancaster, CA
National Provider Identifier
1700841939
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11937TLG Issued in CA
Legal business name
DR LUQUE OD, APOC
Practice address
44665 Valley Central Way
Lancaster, CA 93536-6500
Phone
(661) 942-7007
Fax
(866) 926-9833
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Lee-Jiuan Luque, O.D.
Title
President
Phone
(661) 942-7007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 11937TLG CA Primary

Addresses

Primary practice location

44665 Valley Central Way
Lancaster, CA 93536-6500

Mailing address

PO Box 801002
Santa Clarita, CA 91380-1002
Phone (661) 942-7007

Other identifiers 1

IdentifierTypeStateIssuer
SD0119370MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1700841939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801002",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913801002",
            "telephone_number": "661-942-7007",
            "fax_number": "866-926-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44665 VALLEY CENTRAL WAY",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935366500",
            "telephone_number": "661-942-7007",
            "fax_number": "866-926-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR LUQUE OD, APOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "LUQUE",
        "authorized_official_first_name": "LEE-JIUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-942-7007",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11937TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0119370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.