Gordon K. Ota, O.D. a Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

7549T Issued in CA

Legal business name

GORDON K. OTA, O.D. A PROFESSIONAL CORPORATION

Practice address

10130 Warner Ave
Suite J
Fountain Valley, CA 92708-1619

Phone

(714) 965-5130

Fax

(714) 965-8265

NPI assigned

Apr 6, 2007

Last updated

Sep 4, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gordon K Ota, O.D.NPI 1154392470

Title

President

Phone

(714) 965-5130

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Gordon Kiyoshi Ota, O.D.

  • Optometrist
  • Fountain Valley, CA
  • NPI 1154392470
  Authorized official Same address or phone

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1871615146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 WARNER AVE",
            "address_2": "SUITE J",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081619",
            "telephone_number": "714-965-5130",
            "fax_number": "714-965-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 WARNER AVE",
            "address_2": "SUITE J",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081619",
            "telephone_number": "714-965-5130",
            "fax_number": "714-965-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON K. OTA, O.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-09-04",
        "status": "A",
        "authorized_official_last_name": "OTA",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-965-5130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7549T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.