Riolan Marbun, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13678 Issued in CA

Practice address

1288 Camino del Rio N
San Diego, CA 92108-1511

Phone

(619) 500-6688

Fax

(619) 500-6689

NPI assigned

Dec 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr Riolan Marbun OD Professional Corporation

  • Optometrist
  • San Diego, CA
  • NPI 1942489547
  Medicare reassignment NPD Authorized official
• Dpmotikonrca LLC

  • Podiatrist
  • Bishop, CA
  • NPI 1285952150
  NPD (past)
• Spectrum Eyecare Optometry Inc

  • Optometrist
  • San Dimas, CA
  • NPI 1801949573
  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1053476788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91519",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921693519",
            "telephone_number": "615-604-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 CAMINO DEL RIO N",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081511",
            "telephone_number": "619-500-6688",
            "fax_number": "619-500-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBUN",
        "first_name": "RIOLAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "13678",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Himani Marar
• S. Mohammad Marashi, M.D.
• Julie Christine Marazzo, DPT
• Bonnie Marblestone
• Taja Reniece Marbley
• Marc Dentico-Olin DMD MD Inc
• Marc Gehr M.D.
• Krishelle Leong Marc-Aurele, MD
• Maria C Marcano
• Marcel T. Bougher, DDS, Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.