Active NPI
David J Liem, O.D.
- Optometrist
- La Habra, CA
National Provider Identifier
1982932877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11793T
- Practice address
- 1390 S Beach Blvd
La Habra, CA 90631-6374 - Phone
- (562) 691-9541
- Fax
- (562) 697-2108
- NPI assigned
- Dec 3, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11793T | CA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 11793T | CA |
Addresses
Primary practice location
1390 S Beach Blvd
La Habra, CA 90631-6374
Mailing address
900 Ridgecrest St
Monterey Park, CA 91754-4623
Phone (626) 221-4952
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050111001104 | CA | Practitioner - Optometry | 7911955315 | Practice locations: La Habra, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1390 S Beach Blvd
La Habra, CA 90631-6374
Phone (562) 691-9541
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11793T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Liem OD and Associates, Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- La Habra, CA
- NPI 1366838633
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1982932877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 RIDGECREST ST",
"city": "MONTEREY PARK",
"state": "CA",
"postal_code": "917544623",
"telephone_number": "626-221-4952",
"fax_number": "562-697-2108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 S BEACH BLVD",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906316374",
"telephone_number": "562-691-9541",
"fax_number": "562-697-2108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEM",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-03",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11793T",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "11793T",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Habra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.