Individual provider Active NPI

Leika Joy Montejo Ilagan, OD

  • Optometrist
  • Rancho Palos Verdes, CA
National Provider Identifier
1790336790
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34397 Issued in CA
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

Updated by the provider on May 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
34397CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Michael S. Chang O.D. Inc. Optometrist CurrentSince Sep 1, 2019 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.

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.

Verify at the official NPI Registry.