Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Keith Michael Wan, OD

Individual provider Optometrist · NPI 1235181165

Dr. Keith Michael Wan, OD is an Optometry in San Diego, California. Graduated from University of California - School of Optometry in 1997, 29 years ago. Practices with Wan and Mashouf Optometric Corp PC, a 4-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
29
Trained at
University of California - School of Optometry
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

10549 Scripps Poway Pkwy Ste G
San Diego, CA 92131-3963
Phone: (858) 530-2800
Fax: (858) 530-2889
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 10924T (CA)

Record details

NPI number1235181165
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedMay 17, 2006
Last updated in NPPESJuly 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolUNIVERSITY OF CALIFORNIA - SCHOOL OF OPTOMETRY
Graduated 1997 (29 years in practice)
Group practice Wan And Mashouf Optometric Corp Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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