Active NPI
Gary Alan Klein, O.D.
- Optometrist
- San Diego, CA
National Provider Identifier
1043489081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9621 TPA
- Practice address
- 3788 Park Blvd
Suite 5
San Diego, CA 92103-0910 - Phone
- (619) 683-2020
- NPI assigned
- Feb 25, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9621 TPA | CA | Primary |
Addresses
Primary practice location
3788 Park Blvd
Suite 5
San Diego, CA 92103-0910
Mailing address
3788 Park Blvd
Suite 5
San Diego, CA 92103-0910
Phone (619) 683-2020
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9621 TPA | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urban Optiks Optometry, Inc | Optometrist | Current | Accepting new patients |
Locations
3788 Park Blvd
Ste 5
San Diego, CA 92103
Phone (619) 683-2020
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1043489081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3788 PARK BLVD",
"address_2": "SUITE 5",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921030910",
"telephone_number": "619-683-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3788 PARK BLVD",
"address_2": "SUITE 5",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921030910",
"telephone_number": "619-683-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN",
"first_name": "GARY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-25",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9621 TPA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.