Active NPI
Eric Koji Miyamoto, O.D
- Optometrist
- Los Angeles, CA
National Provider Identifier
1902957418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9309
- Practice address
- 420 E 3Rd St
Suite 603
Los Angeles, CA 90013-1644 - Phone
- (213) 680-1551
- NPI assigned
- Jan 13, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 9309 | CA | Primary |
Addresses
Primary practice location
420 E 3Rd St
Suite 603
Los Angeles, CA 90013-1644
Mailing address
12155 Stone Gate Way
Northridge, CA 91326-3854
Phone (818) 832-3933
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9309 | CA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East-West Eye Institute a Medical Corporation | Past | Accepting new patients | |
| Eric Miyamoto, Inc. | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Los Angeles, CA
- NPI 1225150147
-
- Ophthalmology Physician
- Los Angeles, CA
- NPI 1710057245
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902957418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12155 STONE GATE WAY",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913263854",
"telephone_number": "818-832-3933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 E 3RD ST",
"address_2": "SUITE 603",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900131644",
"telephone_number": "213-680-1551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIYAMOTO",
"first_name": "ERIC",
"middle_name": "KOJI",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9309",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.