Active NPI
Maria Theresa Gozun Alfonso, OD
- Optometrist
- El Cajon, CA
National Provider Identifier
1003150129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 14354
- Practice address
- 539 Parkway PLZ
El Cajon, CA 92020-2532 - Phone
- (619) 441-0138
- NPI assigned
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14354 | CA | Primary |
Addresses
Primary practice location
539 Parkway PLZ
El Cajon, CA 92020-2532
Mailing address
11134 Rancho Carmel Dr
San Diego, CA 92128-4671
Phone (858) 673-1084
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14354 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1003150129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11134 RANCHO CARMEL DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921284671",
"telephone_number": "858-673-1084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "539 PARKWAY PLZ",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920202532",
"telephone_number": "619-441-0138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALFONSO",
"first_name": "MARIA THERESA",
"middle_name": "GOZUN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.