Individual provider Active NPI

Steven S Yoo, O.D.

  • Optometrist
  • Garden Grove, CA
National Provider Identifier
1821130238
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10099T Issued in CA
Practice address
9042 Garden Grove Blvd Ste 110
Garden Grove, CA 92844-1370
Phone
(714) 530-6611
Fax
(714) 415-5512
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10099T CA Primary

Addresses

Primary practice location

9042 Garden Grove Blvd Ste 110
Garden Grove, CA 92844-1370

Mailing address

9042 Garden Grove Blvd
Ste 110
Garden Grove, CA 92844-1370
Phone (714) 530-6611

Other identifiers 1

IdentifierTypeStateIssuer
SD0100990MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120503000119 CA Practitioner - Optometry 2860654175 Practice locations: Garden Grove, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9042 Garden Grove Blvd
Garden Grove, CA 92844-1370
Phone (714) 530-6611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10099TCAMDOptometrist
10099CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1821130238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9042 GARDEN GROVE BLVD",
            "address_2": "STE 110",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441370",
            "telephone_number": "714-530-6611",
            "fax_number": "714-415-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9042 GARDEN GROVE BLVD STE 110",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441370",
            "telephone_number": "714-530-6611",
            "fax_number": "714-415-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "STEVEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10099T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0100990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.