NPIMap

Organization Active NPI

Siems Advanced Lasik and Eye Centers

  • Corneal and Contact Management Optometrist
  • Corona del Mar, CA
National Provider Identifier
1023238953
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
8933T Issued in CA
Legal business name
SIEMS ADVANCED LASIK AND EYE CENTERS
Practice address
2121 E Coast Hwy
Ste 200
Corona del Mar, CA 92625-1931
Phone
(949) 718-2010
Fax
(949) 718-2011
NPI assigned
Apr 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rickie Elpusan
Title
Ophthalmic Technician
Phone
(949) 718-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WC0802X 8933T CA Primary

Addresses

Primary practice location

2121 E Coast Hwy
Ste 200
Corona del Mar, CA 92625-1931

Mailing address

2121 E Coast Hwy
Ste 200
Corona del Mar, CA 92625-1931
Phone (949) 718-2010

Other identifiers 1

IdentifierTypeStateIssuer
2018998MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023238953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E COAST HWY",
            "address_2": "STE 200",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251931",
            "telephone_number": "949-718-2010",
            "fax_number": "949-718-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E COAST HWY",
            "address_2": "STE 200",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251931",
            "telephone_number": "949-718-2010",
            "fax_number": "949-718-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIEMS ADVANCED LASIK AND EYE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELPUSAN",
        "authorized_official_first_name": "RICKIE",
        "authorized_official_title_or_position": "OPHTHALMIC TECHNICIAN",
        "authorized_official_telephone_number": "949-718-2010"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "8933T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018998",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.