Shelly A Fukunaga, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10849T Issued in CA

Practice address

2130 Redondo Beach Blvd.
Suite G
Torrance, CA 90504

Phone

(310) 538-9797

Fax

(310) 538-1725

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

University of California - School of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marilyn Hernandez OD IncGroup PAC ID 1658719430, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Marilyn Hernandez, O.D., Inc.

  • Optometrist
  • Torrance, CA
  • NPI 1962264010
  Medicare reassignment Care Compare group NPD
• Paul S. Hirano

  • Optometrist
  • Torrance, CA
  • NPI 1124025960
  Medicare reassignment
• Raj U. Dugel MD Inc

  • Specialist
  • Torrance, CA
  • NPI 1194911594
  NPD

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1710002498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 REDONDO BEACH BLVD.",
            "address_2": "SUITE G",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90504",
            "telephone_number": "310-538-9797",
            "fax_number": "310-538-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 REDONDO BEACH BLVD.",
            "address_2": "SUITE G",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90504",
            "telephone_number": "310-538-9797",
            "fax_number": "310-538-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUNAGA",
        "first_name": "SHELLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10849T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "10849T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wakana Fujiwara
• Nicole Fujiyama, ND, LAC
• Alice Reina Fukui, D.D.S.
• Alex Fukunaga, MD
• Karl Ken Fukunaga, MD
• Janice Y Fukushima, DDS
• Kaori Fukuzato, RN
• Full Circle Premium Health a Professional Nursing Corporation
• Maria Reyda Roxas Fuller, RN
• Ryan Fuller

• Optometrist in Torrance, CA
• Providers in Torrance, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.