Eyexam of California
Organization Active NPI Health Maintenance Organization · West Covina, CA
NPI 1003203852 · NPPES record last updated Apr 20, 2015
Key facts
- NPI
- 1003203852
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Maintenance Organization 302R00000X
- License
- 15144TLG (CA)
- Legal business name
- EYEXAM OF CALIFORNIA
- Practice address
- 496 Plaza Dr
West Covina, CA 91790-2854 - Phone
- (626) 814-4681
- NPI assigned
- Apr 20, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Randi McMichael, O.D.
- Title
- Optometrist
- Phone
- (617) 866-7582
Corporate family (same tax ID) 5
National Provider Directory
- Tax ID family
- Eyexam of California
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | 15144TLG | CA | Yes |
Addresses
Primary practice location
496 Plaza Dr
West Covina, CA 91790-2854
Mailing address
496 Plaza Dr
West Covina, CA 91790-2854
NPI Registry JSON
{
"created_epoch": "1429488000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1429488000000",
"number": "1003203852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "496 PLAZA DR",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 PLAZA DR",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902854",
"telephone_number": "626-814-4681"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EYEXAM OF CALIFORNIA",
"organizational_subpart": "NO",
"enumeration_date": "2015-04-20",
"last_updated": "2015-04-20",
"status": "A",
"authorized_official_last_name": "MCMICHAEL",
"authorized_official_first_name": "RANDI",
"authorized_official_title_or_position": "OPTOMETRIST",
"authorized_official_telephone_number": "617-866-7582",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "CA",
"license": "15144TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
- Evelyn a Ortega MD Inc
- Evolution Consulting Inc.
- Moses Ewo
- Excel Imaging Center West Covina Inc.
- Eyehome Network of California, an Optometric Corporation
- Anthony Curtis Ezedi
- Fairway Children'S Medical Group
- Natalia Isabel Fajardo
- David Falcon-Valentin
- Raymon Joe Falcon
All providers in West Covina, CA · Health Maintenance Organization in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.