NPIMap

Organization Active NPI

Dr Patricia Chang Optometric Group Inc.

  • Optometrist
  • Millbrae, CA
National Provider Identifier
1861544975
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1080 Issued in CA
Legal business name
DR PATRICIA CHANG OPTOMETRIC GROUP INC.
Practice address
305 Broadway
Millbrae, CA 94030-2509
Phone
(650) 697-2475
Fax
(650) 692-7154
NPI assigned
Jan 17, 2007
Last updated
Mar 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Authorized official

Name
Patricia Chang, O.D.NPI 1386796480
Title
President
Phone
(650) 697-2475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1080 CA Primary

Addresses

Primary practice location

305 Broadway
Millbrae, CA 94030-2509

Mailing address

305 Broadway
Millbrae, CA 94030-2509
Phone (650) 697-2475

Other names 1

  • Carlmont Optometry Other name

National Provider Directory

National Provider Directory

Locations

1019 Alameda de las Pulgas
Belmont, CA 94002
Phone (650) 594-1019

305 Broadway
Millbrae, CA 94030
Phone (415) 589-4130

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1861544975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BROADWAY",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302509",
            "telephone_number": "650-697-2475",
            "fax_number": "650-692-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BROADWAY",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302509",
            "telephone_number": "650-697-2475",
            "fax_number": "650-692-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PATRICIA CHANG OPTOMETRIC GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-697-2475",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "1080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carlmont Optometry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Millbrae, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.