Active NPI
Leika Joy Montejo Ilagan, OD
- Optometrist
- Rancho Palos Verdes, CA
National Provider Identifier
1790336790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 34397
- Practice address
- 28356 S Western Ave
Rancho Palos Verdes, CA 90275-1434 - Phone
- (310) 831-0841
- NPI assigned
- Sep 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 34397 | CA | Primary |
Addresses
Primary practice location
28356 S Western Ave
Rancho Palos Verdes, CA 90275-1434
Mailing address
2605 W 235TH St Apt D
Torrance, CA 90505-4242
Phone (510) 378-0077
Other practice location 1
17801 Pioneer Blvd Ste F
Artesia, CA 90701-3962
Phone (562) 467-0813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34397 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Michael S. Chang O.D. Inc. | Optometrist | Current | Accepting new patients |
Locations
17801 Pioneer Blvd
Ste F
Artesia, CA 90701
Phone (562) 239-2240
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Artesia, CA
- NPI 1952573982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682985600000",
"number": "1790336790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2605 W 235TH ST APT D",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905054242",
"telephone_number": "510-378-0077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28356 S WESTERN AVE",
"city": "RANCHO PALOS VERDES",
"state": "CA",
"postal_code": "902751434",
"telephone_number": "310-831-0841"
}
],
"practiceLocations": [
{
"address_1": "17801 Pioneer Blvd Ste F",
"address_purpose": "LOCATION",
"city": "Artesia",
"state": "CA",
"postal_code": "907013962",
"country_code": "US",
"telephone_number": "562-467-0813",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ILAGAN",
"first_name": "LEIKA JOY",
"middle_name": "MONTEJO",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-23",
"last_updated": "2023-05-02",
"certification_date": "2023-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "34397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rancho Palos Verdes, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.