Active NPI
Scott Randall Hultman, O,D.
- Optometrist
- Fresno, CA
National Provider Identifier
1013038405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10083
- Practice address
- 3636 N Blackstone Ave
Fresno, CA 93726-5304 - Phone
- (559) 244-3319
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- 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 | 10083 | CA | Primary |
Addresses
Primary practice location
3636 N Blackstone Ave
Fresno, CA 93726-5304
Mailing address
8199 N Sierra Vista Ave
Fresno, CA 93720-0469
Phone (559) 325-8005
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 |
|---|---|---|---|
| 10083 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013038405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8199 N SIERRA VISTA AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937200469",
"telephone_number": "559-325-8005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3636 N BLACKSTONE AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937265304",
"telephone_number": "559-244-3319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HULTMAN",
"first_name": "SCOTT",
"middle_name": "RANDALL",
"name_prefix": "Dr.",
"credential": "O,D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.