Active NPI
Kevin Quoc Lu, O.D.
- Optometrist
- Montclair, CA
National Provider Identifier
1871629923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10715T
- Practice address
- 9197 Central Ave Ste D
Montclair, CA 91763-1616 - Phone
- (909) 626-1412
- NPI assigned
- Feb 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 10715T | CA | Primary |
Addresses
Primary practice location
9197 Central Ave Ste D
Montclair, CA 91763-1616
Mailing address
9197 Central Ave Ste D
Montclair, CA 91763-1616
Phone (909) 626-1412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871629923 | Medicaid | CA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1871629923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9197 CENTRAL AVE STE D",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917631616",
"telephone_number": "909-626-1412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9197 CENTRAL AVE STE D",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917631616",
"telephone_number": "909-626-1412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LU",
"first_name": "KEVIN",
"middle_name": "QUOC",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-25",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10715T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871629923",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montclair, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.