NPIMap

Organization Active NPI

Yuan Optometry, a Professional Corporation

  • Clinic/Center
  • Carson, CA
National Provider Identifier
1770154049
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
YUAN OPTOMETRY, A PROFESSIONAL CORPORATION
Practice address
22015 Avalon Blvd Ste a
Carson, CA 90745-3355
Phone
(310) 830-7584
Fax
(310) 830-5856
NPI assigned
Jul 7, 2021
Last updated
Nov 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Authorized official

Name
Dr. Ryan Yuan, ODNPI 1558982132
Title
President
Phone
(310) 830-7584

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

22015 Avalon Blvd Ste a
Carson, CA 90745-3355

Mailing address

22015 Avalon Blvd Ste a
Carson, CA 90745-3355
Phone (310) 830-7584

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211222002147 CA Part B Supplier - Clinic/Group Practice 7012308299 Receives reassigned benefits from 6 practitioners
Practice locations: Carson, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1770154049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22015 AVALON BLVD STE A",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453355",
            "telephone_number": "310-830-7584",
            "fax_number": "310-830-5856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22015 AVALON BLVD STE A",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453355",
            "telephone_number": "310-830-7584",
            "fax_number": "310-830-5856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUAN OPTOMETRY, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "YUAN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-830-7584",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.