Elliot Gregory Kamin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

11363T Issued in CA

Practice address

1900 Davis St
San Leandro, CA 94577-1209

Phone

(510) 632-5210

Fax

(510) 632-5704

NPI assigned

Jan 12, 2007

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1033269683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945771209",
            "telephone_number": "510-632-5210",
            "fax_number": "510-632-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945771209",
            "telephone_number": "510-632-5210",
            "fax_number": "510-632-5704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3251 20th Ave",
            "address_2": "STONESTOWN GALLERIA Space 129",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941321900",
            "country_code": "US",
            "telephone_number": "415-566-8394",
            "fax_number": "415-566-9187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMIN",
        "first_name": "ELLIOT",
        "middle_name": "GREGORY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11363T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.