John J. Mielke, O.D. Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT10377 Issued in CA

Legal business name

JOHN J. MIELKE, O.D. INC.

Practice address

801 S Chevy Chase Dr Ste 100
Glendale, CA 91205-4437

Phone

(818) 956-8785

Fax

(818) 956-5367

NPI assigned

Oct 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John Jeffrey Mielke, O.D.NPI 1992766646

Title

Owner

Phone

(818) 956-8785

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

John J Mielke OD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• John J. Mileke, OD, Inc.

  • Optometrist
  • Glendale, CA
  • NPI 1538106984
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John J. Mielke, O.D.

  • Optometrist
  • Glendale, CA
  • NPI 1992766646
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1013169127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S. CHECY CHASE DRIVE",
            "address_2": "STE. 100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054431",
            "telephone_number": "818-956-8785",
            "fax_number": "818-956-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054437",
            "telephone_number": "818-956-8785",
            "fax_number": "818-956-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J. MIELKE, O.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "MIELKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-956-8785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT10377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Akamatsu, O.D., Inc
• John C. Gunnell, M.D.
• John G Olea, MD Apc
• John Gazarian DDS Inc
• John J. Guagenti, M.D. Inc.
• John J. Mileke, OD, Inc.
• John P McKenzie III M D Inc
• John R. Debanto, MD, Inc.
• John V. Agapian, M.D.
• Akimi Jaclyn Johnson

• Optometrist in Glendale, CA
• Providers in Glendale, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.