Organization Active NPI

Katie W. Chu, O.D., Inc.

  • Optometrist
  • Rosemead, CA
National Provider Identifier
1891865267
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
COR 1116 Issued in CA
Legal business name
KATIE W. CHU, O.D., INC.
Practice address
3106 San Gabriel Blvd
Unit H
Rosemead, CA 91770-2579
Phone
(626) 288-6278
Fax
(626) 571-1868
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Katie Wankay Chu, O.D.NPI 1689756629
Title
President
Phone
(626) 298-0790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X COR 1116 CA Primary

Addresses

Primary practice location

3106 San Gabriel Blvd
Unit H
Rosemead, CA 91770-2579

Mailing address

3106 San Gabriel Blvd
Unit H
Rosemead, CA 91770-2579
Phone (626) 288-6278

Other identifiers 1

IdentifierTypeStateIssuer
SD0106050MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060223000788 CA Part B Supplier - Clinic/Group Practice 5890701122 Receives reassigned benefits from 1 practitioner
Practice locations: Rosemead, CA

National Provider Directory

National Provider Directory

Locations

3106 San Gabriel Blvd
Ste H
Rosemead, CA 91770
Phone (310) 462-4806

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891865267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 SAN GABRIEL BLVD",
            "address_2": "UNIT H",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917702579",
            "telephone_number": "626-288-6278",
            "fax_number": "626-571-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 SAN GABRIEL BLVD",
            "address_2": "UNIT H",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917702579",
            "telephone_number": "626-288-6278",
            "fax_number": "626-571-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATIE W. CHU, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "WANKAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-298-0790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "COR 1116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.