Lawrence K Wan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

07675 TPA Issued in CA

Practice address

338 E Hamilton Ave
Campbell, CA 95008-0207

Phone

(408) 866-2020

Fax

(408) 370-3937

NPI assigned

Mar 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peter W Ross OD & Larry K Wan OD Inc

  • Optometrist
  • Campbell, CA
  • NPI 1679601066
  NPD

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1962471664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 E HAMILTON AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080207",
            "telephone_number": "408-866-2020",
            "fax_number": "408-370-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 E HAMILTON AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080207",
            "telephone_number": "408-866-2020",
            "fax_number": "408-370-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "LAWRENCE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "07675 TPA",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "07675 TPA",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "07675 TPA",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damien Wallace
• Kayla Wallace, BCBA
• Suzanna Walter, OTR/L
• Mary Jean Walton
• Mary R. Waltz, M.A.
• Wang Chiropractic
• Isaac Wang
• Lynna Hwang Wang, MD
• James William Wardle, L.C.S.W.
• Nicole Washington

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.