Individual provider Active NPI

Mark Anthony Galvan, O.D.

  • Optometrist
  • Whittier, CA
National Provider Identifier
1043426927
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
07192T Issued in CA
Practice address
6711 Comstock Ave
Whittier, CA 90601-4106
Phone
(562) 698-0027
Fax
(562) 693-4418
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 07192T CA Primary

Addresses

Primary practice location

6711 Comstock Ave
Whittier, CA 90601-4106

Mailing address

6711 Comstock Ave
Whittier, CA 90601-4106
Phone (562) 698-0027

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
07192TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1043426927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6711 COMSTOCK AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014106",
            "telephone_number": "562-698-0027",
            "fax_number": "562-693-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6711 COMSTOCK AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014106",
            "telephone_number": "562-698-0027",
            "fax_number": "562-693-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVAN",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "07192T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.