Individual provider Active NPI

Loretta Mui-Wan Li, O.D.

  • Optometrist
  • Westminster, CA
National Provider Identifier
1851429369
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7514T Issued in CA
Practice address
9022 Bolsa Ave
Westminster, CA 92683-5531
Phone
(714) 892-3636
Fax
(714) 892-6273
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7514T CA Primary

Addresses

Primary practice location

9022 Bolsa Ave
Westminster, CA 92683-5531

Mailing address

9022 Bolsa Ave
Westminster, CA 92683-5531
Phone (714) 892-3636

Other identifiers 1

IdentifierTypeStateIssuer
SD0075140MedicaidCA

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
I20101022001084 CA Practitioner - Optometry 0749473734 Practice locations: Westminster, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7514CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Loretta M Li OD Optometrist PastSince Jul 1, 1988 Accepting new patients

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1851429369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9022 BOLSA AVE",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835531",
            "telephone_number": "714-892-3636",
            "fax_number": "714-892-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9022 BOLSA AVE",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835531",
            "telephone_number": "714-892-3636",
            "fax_number": "714-892-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "LORETTA",
        "middle_name": "MUI-WAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7514T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0075140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.