Grace Jing-Wei Pan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 13882 TPL Issued in CA

Practice address

10123 N Wolfe Rd
Suite 2144
Cupertino, CA 95014-2509

Phone

(408) 446-4004

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1891809729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10123 N WOLFE RD",
            "address_2": "SUITE 2144",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142509",
            "telephone_number": "408-446-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 N WOLFE RD",
            "address_2": "SUITE 2144",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142509",
            "telephone_number": "408-446-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "GRACE",
        "middle_name": "JING-WEI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009853",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 13882 TPL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelikki A Pagonis, D.D.S.
• Gary E Pagonis, DDS
• Nicole E Pagonis, DDS
• Kiran Pala, LMFT
• Adonia Palacio
• Willy Y Pan, D.D.S.
• Pang Physical Therapy Inc
• Allan Y. Pang, DDS
• Sachin Shrikant Parikh, M.D.
• Chau Le Park, D.P.T.

• Optometrist in Cupertino, CA
• Providers in Cupertino, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.