Active NPI
Deborah Carrasco, OD
- Optometrist
- Redondo Beach, CA
National Provider Identifier
1003535659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10977T
- Practice address
- 520 N Prospect Ave Ste 206
Redondo Beach, CA 90277-3042 - Phone
- (310) 376-8850
- Fax
- (310) 798-9228
- NPI assigned
- Aug 25, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 10977T | CA | Primary |
Addresses
Primary practice location
520 N Prospect Ave Ste 206
Redondo Beach, CA 90277-3042
Mailing address
520 N Prospect Ave Ste 206
Redondo Beach, CA 90277-3042
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10977T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1003535659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 N PROSPECT AVE STE 206",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902773042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N PROSPECT AVE STE 206",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902773042",
"telephone_number": "310-376-8850",
"fax_number": "310-798-9228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRASCO",
"first_name": "DEBORAH",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-25",
"last_updated": "2022-09-29",
"certification_date": "2022-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10977T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.