Dr. Si Pokpongkiat Optometry,Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

9071T Issued in CA

Legal business name

DR. SI POKPONGKIAT OPTOMETRY,INC.

Practice address

1609 N Vermont Ave
Los Angeles, CA 90027-5312

Phone

(323) 663-8346

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Si Pokpongkiat, O.D.

Title

President

Phone

(323) 663-8346

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1962628164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275312",
            "telephone_number": "323-663-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275312",
            "telephone_number": "323-663-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SI POKPONGKIAT OPTOMETRY,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "POKPONGKIAT",
        "authorized_official_first_name": "SI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-663-8346",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9071T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL  NPI",
            "identifier": "1558443192",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0090710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.