Individual provider Active NPI

Helen Ahn, OD

  • Optometrist
  • San Leandro, CA
National Provider Identifier
1871015719
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33769TLG Issued in CA
Practice address
276 Dolores Ave
San Leandro, CA 94577-5008
Phone
(510) 614-1515
Fax
(510) 357-6330
NPI assigned
Jul 12, 2017
Last updated
Aug 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33769TLG CA Primary

Addresses

Primary practice location

276 Dolores Ave
San Leandro, CA 94577-5008

Mailing address

904 Cedar St
Santa Cruz, CA 95060-3802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33769TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Network, LLC PastSince May 1, 2022 Accepting new patients
Community Hospital of the Monterey Peninsula Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1871015719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 CEDAR ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 DOLORES AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775008",
            "telephone_number": "510-614-1515",
            "fax_number": "510-357-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "HELEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2020-08-31",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33769TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.