Active NPI
Marilyn A Carter, OD
- Optometrist
- El Cajon, CA
National Provider Identifier
1003884776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4790TPA
- Practice address
- 510 S Magnolia Ave
El Cajon, CA 92020 - Phone
- (619) 444-9012
- Fax
- (619) 444-0232
- NPI assigned
- Mar 9, 2006
- 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 | 4790TPA | CA | Primary |
Addresses
Primary practice location
510 S Magnolia Ave
El Cajon, CA 92020
Mailing address
330 Oxford St
#206
Chula Vista, CA 91911
Phone (619) 422-5361
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0P4790 | Medicaid | CA |
Other names 1
- Marilyn A Evans
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 |
|---|---|---|---|
| 4790TPA | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491177600000",
"number": "1003884776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 OXFORD ST",
"address_2": "#206",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "91911",
"telephone_number": "619-422-5361",
"fax_number": "619-422-7021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S MAGNOLIA AVE",
"city": "EL CAJON",
"state": "CA",
"postal_code": "92020",
"telephone_number": "619-444-9012",
"fax_number": "619-444-0232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "MARILYN",
"middle_name": "A",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-09",
"last_updated": "2017-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "4790TPA",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0P4790",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARILYN",
"last_name": "EVANS",
"middle_name": "A",
"code": "5",
"type": "Other Name"
}
]
}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 Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.