La Mirada Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

LA MIRADA OPTOMETRY

Practice address

12819 Valley View Ave
La Mirada, CA 90638-1945

Phone

(562) 921-6659

Fax

(562) 921-6659

NPI assigned

May 27, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Debbie Chen-Bennett, OD

Title

Optometrist

Phone

(714) 625-6433

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1982227823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10562 RITTER ST",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304944",
            "telephone_number": "714-625-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12819 VALLEY VIEW AVE",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381945",
            "telephone_number": "562-921-6659",
            "fax_number": "562-921-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MIRADA OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "CHEN-BENNETT",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "714-625-6433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800341287",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kwangsun C Shin
• Young Je Kwon
• La Mirada Family Dental
• La Mirada Healtchare LLC
• La Mirada Healthcare, LLC
• La Mirada Optometry, Inc.
• La Mirada Post Acute LLC
• Maria Elizabeth Ladd, R.D.H.A.P.
• Jayanne Lagare
• Mary Louise Lane-Carlson, EDD, MPH, RD, CDE

• Optometrist in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.

Verify at the official NPI Registry.