NPIMap

Organization Active NPI

Boaz Eyewear Opt,Inc

  • Optician
  • Los Angeles, CA
National Provider Identifier
1881330876
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
BOAZ EYEWEAR OPT,INC
Practice address
621 S Western Ave Ste 214
Los Angeles, CA 90005-3042
Phone
(213) 389-1001
Fax
(213) 389-1002
NPI assigned
May 11, 2022
Last updated
May 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Authorized official

Name
Mr. Kyu Hwan Jang, OPTICIAN
Title
Ceo
Phone
(213) 389-1001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

621 S Western Ave Ste 214
Los Angeles, CA 90005-3042

Mailing address

621 S Western Ave Ste 214
Los Angeles, CA 90005-3042

National Provider Directory

National Provider Directory

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": "1652227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1881330876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S WESTERN AVE STE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S WESTERN AVE STE 214",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053042",
            "telephone_number": "213-389-1001",
            "fax_number": "213-389-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOAZ EYEWEAR OPT,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-07",
        "status": "A",
        "authorized_official_last_name": "JANG",
        "authorized_official_first_name": "KYU HWAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-389-1001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.