Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Gordon Kiyoshi OTA, OD

Individual provider Optometrist · NPI 1154392470

Dr. Gordon Kiyoshi OTA, OD is an Optometrist in Fountain Valley, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

10130 Warner Ave Ste J
Fountain Valley, CA 92708-1619
Phone: (714) 965-5130
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence T7549 (CA)

Record details

NPI number1154392470
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJanuary 27, 2006
Last updated in NPPESSeptember 5, 2012

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