Dr Sarah K Ito O D a Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

10084T Issued in CA

Legal business name

DR SARAH K ITO O D A PROFESSIONAL CORPORATION

Practice address

2605 Lincoln Blvd
Santa Monica, CA 90405-4619

Phone

(310) 452-1039

Fax

(310) 452-1831

NPI assigned

Mar 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sarah Ito, O.D.NPI 1740271832

Title

President

Phone

(310) 452-1039

Specialties & licenses 1

Addresses

Other names 1

• Ocean Park Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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

• Sarah Ito, O.D.

  • Optometrist
  • Santa Monica, CA
  • NPI 1740271832
  Medicare reassignment Care Compare group NPD Authorized official
• Klaus Ito, OD

  • Optometrist
  • Charlottesville, VA
  • NPI 1851961411

  CA

  Medicare reassignment Care Compare group NPD
• Magdalena Fuentes

  • Optometrist
  • Inglewood, CA
  • NPI 1932617909
  Medicare reassignment NPD
• Tina Nguyen, OD

  • Optometrist
  • Costa Mesa, CA
  • NPI 1255942207
  Medicare reassignment NPD

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1801910724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 LINCOLN BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054619",
            "telephone_number": "310-452-1039",
            "fax_number": "310-452-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 LINCOLN BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054619",
            "telephone_number": "310-452-1039",
            "fax_number": "310-452-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR SARAH K ITO O D A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-17",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "ITO",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-452-1039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10084T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ocean Park Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.