Individual provider Active NPI

Eloisa Anguiano Morfin, OD

  • Optometrist
  • Mill Valley, CA
National Provider Identifier
1003657545
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35742 Issued in CA
Practice address
158 Throckmorton Ave
Mill Valley, CA 94941-1919
Phone
(415) 388-8262
NPI assigned
Jun 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35742 CA Primary

Addresses

Primary practice location

158 Throckmorton Ave
Mill Valley, CA 94941-1919

Mailing address

1963 Will O View Cir
Lakeport, CA 95453-3052

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

LicenseStateTypeSpecialty
35742CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jean S. Brennan O.D., a Professional Corp. Optometrist CurrentSince Jun 9, 2024 Accepting new patients
Morfin, O.D., Optometric Corporation Optometrist PastSince Jun 9, 2024 Accepting new patients
Channie Duhn OD a Professional Corp Optometrist PastSince Jun 9, 2024 Accepting new patients

Locations

158 Throckmorton Ave
Mill Valley, CA 94941
Phone (415) 388-8262

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1003657545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 WILL O VIEW CIR",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954533052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 THROCKMORTON AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411919",
            "telephone_number": "415-388-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORFIN",
        "first_name": "ELOISA",
        "middle_name": "ANGUIANO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.