Organization Active NPI

Eric J Kawata O D Inc

  • Optometrist
  • Anaheim, CA
National Provider Identifier
1760626659
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
08259T Issued in CA
Legal business name
ERIC J KAWATA O D INC
Practice address
101 E Lincoln Ave
Suite 103
Anaheim, CA 92805-3202
Phone
(714) 535-7515
Fax
(714) 535-1870
NPI assigned
Apr 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Authorized official

Name
Dr. Eric J Kawata, ODNPI 1689708778
Title
President
Phone
(714) 535-7515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 08259T CA Primary

Addresses

Primary practice location

101 E Lincoln Ave
Suite 103
Anaheim, CA 92805-3202

Mailing address

101 E Lincoln Ave
Suite 103
Anaheim, CA 92805-3202
Phone (714) 535-7515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091125000192 CA Part B Supplier - Clinic/Group Practice 0042359499 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

101 E Lincoln Ave
Ste 103
Anaheim, CA 92805
Phone (714) 535-7515

Practitioners & affiliated clinicians

Practitioners 2

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": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1760626659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E LINCOLN AVE",
            "address_2": "SUITE 103",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053202",
            "telephone_number": "714-535-7515",
            "fax_number": "714-535-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E LINCOLN AVE",
            "address_2": "SUITE 103",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053202",
            "telephone_number": "714-535-7515",
            "fax_number": "714-535-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC J KAWATA O D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "KAWATA",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-535-7515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "08259T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.