Active NPI
Bonnie Jansum Chan
- Optometrist
- Pasadena, CA
National Provider Identifier
1962042994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 34632
- Practice address
- 2700 E Foothill Blvd
Pasadena, CA 91107-7100 - Phone
- (626) 578-9685
- NPI assigned
- Jan 7, 2020
- Sex
- Female
- 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 | 34632 | CA | Primary |
Addresses
Primary practice location
2700 E Foothill Blvd
Pasadena, CA 91107-7100
Mailing address
953 Clear Creek Canyon Dr
Diamond Bar, CA 91765-2308
Phone (909) 610-5442
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597276800000",
"number": "1962042994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "953 CLEAR CREEK CANYON DR",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917652308",
"telephone_number": "909-610-5442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 E FOOTHILL BLVD",
"city": "PASADENA",
"state": "CA",
"postal_code": "911077100",
"telephone_number": "626-578-9685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "BONNIE",
"middle_name": "JANSUM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-07",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "34632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.