Elite Eye Care Optometry Group

Primary specialty

OptometristTaxonomy code 152W00000X

License

13260T Issued in CA

Legal business name

ELITE EYE CARE OPTOMETRY GROUP

Doing business as

Vista Eye Center Optometry

Practice address

20568 Stevens Creek Blvd
Cupertino, CA 95014-2130

Phone

(408) 777-9000

Fax

(408) 777-9009

NPI assigned

Oct 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Derrick T. Koo, O.D.

Title

President

Phone

(408) 777-9000

Specialties & licenses 1

Addresses

Other names 1

• Vista Eye Center Optometry Doing business as

Locations

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1841526852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20568 STEVENS CREEK BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142130",
            "telephone_number": "408-777-9000",
            "fax_number": "408-777-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20568 STEVENS CREEK BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142130",
            "telephone_number": "408-777-9000",
            "fax_number": "408-777-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE EYE CARE OPTOMETRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "KOO",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-777-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13260T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Eye Center Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Egetgoing
• Petra A Eggert, DC PT
• Tamara Eichelberger, PHD, PT
• Tarek El-Sawy, M.D.
• Sherene El-Sioufi, D.O.
• Elite Plus Medical Clinic Inc
• Emerging Vision Inc
• Kortney Lee Eng, M.S., CCC-SLP
• Enyu Ma (Grace Healing)
• Epism Inc (Ootherapy)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; 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.