Pacific Vision Care, Optometric Services, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

11781TLG Issued in CA

Legal business name

PACIFIC VISION CARE, OPTOMETRIC SERVICES, INC.

Practice address

5532 Woodruff Ave
Lakewood, CA 90713-1535

Phone

(562) 867-2020

Fax

(562) 867-6100

NPI assigned

Nov 15, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Derrick En-Pei Woo, O.D.NPI 1831106491

Title

President/Optometrist

Phone

(562) 867-2020

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Derrick En-Pei Woo, OD

  • Optometrist
  • Lakewood, CA
  • NPI 1831106491
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1416009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416009600000",
    "number": "1780080994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5532 WOODRUFF AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131535",
            "telephone_number": "562-867-2020",
            "fax_number": "562-867-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5532 WOODRUFF AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131535",
            "telephone_number": "562-867-2020",
            "fax_number": "562-867-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC VISION CARE, OPTOMETRIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-15",
        "last_updated": "2014-11-15",
        "status": "A",
        "authorized_official_last_name": "WOO",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "EN-PEI",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "562-867-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11781TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0117810",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "02-6308745",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11781TLG",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11934066",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2014; 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.