West Coast Optometric Group
Organization Active NPI Optometrist · Mission Viejo, CA
NPI 1912436593 · NPPES record last updated Jan 10, 2020
Key facts
- NPI
- 1912436593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- WEST COAST OPTOMETRIC GROUP
- Practice address
- 27724 Santa Margarita Pkwy
Mission Viejo, CA 92691-6653 - Phone
- (949) 583-0422
- NPI assigned
- Jun 7, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Anna Kame, OD
- Title
- Cfo
- Phone
- (714) 646-9871
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240923001496 | CA | Part B Supplier - Clinic/Group Practice | 6507139664 |
Receives reassigned benefits from 1 practitioner Practice locations: Mission Viejo, CA |
National Provider Directory
Locations
27682 Santa Margarita Pkwy
Mission Viejo, CA 92691
Phone (949) 583-0422
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
27724 Santa Margarita Pkwy
Mission Viejo, CA 92691-6653
Mailing address
3038 E Stearns St
Brea, CA 92821-4710
Other providers in Mission Viejo, CA
- Wellness RX Physical Therapy, Inc.
- Phillip R Wells
- Salomeh Wells
- Brett Michael Wertman
- Wesley Y Kim M.D., Inc.
- Linda L. West
- Gary R Westad
- Western Anesthesia Medical Associates Inc
- Western Pacific Med-Corp
- Western Youth Services
All providers in Mission Viejo, CA · Optometrist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.