Organization Active NPI

Stephen G Bornfeld OD Inc

  • Optometrist
  • Arcadia, CA
National Provider Identifier
1013255959
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 5505 TPL Issued in CA
Legal business name
STEPHEN G BORNFELD OD INC
Practice address
622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone
(626) 446-2122
Fax
(626) 446-0513
NPI assigned
Jan 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Authorized official

Name
Stephen G Bornfeld, O.D.
Title
President
Phone
(626) 446-2122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT 5505 TPL CA Primary

Addresses

Primary practice location

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606

Mailing address

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone (626) 446-2122

Other identifiers 1

IdentifierTypeStateIssuer
SD0055050MedicaidCA

National Provider Directory

National Provider Directory

Locations

1450 San Pablo St
#5705
Los Angeles, CA 90033

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1013255959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W DUARTE RD",
            "address_2": "SUITE 101",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077606",
            "telephone_number": "626-446-2122",
            "fax_number": "626-446-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W DUARTE RD",
            "address_2": "SUITE 101",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077606",
            "telephone_number": "626-446-2122",
            "fax_number": "626-446-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN G BORNFELD OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "BORNFELD",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-446-2122",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 5505 TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0055050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.