Individual provider Active NPI

Michael Lawrence Byrne, O.D.

  • Optometrist
  • La Mirada, CA
National Provider Identifier
1063597102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP4891T Issued in CA
Practice address
12819 Valley View Ave
La Mirada, CA 90638-1945
Phone
(562) 921-6659
Fax
(562) 921-9374
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP4891T CA Primary

Addresses

Primary practice location

12819 Valley View Ave
La Mirada, CA 90638-1945

Mailing address

6 Deerfield PL
Trabuco Canyon, CA 92679-1400
Phone (949) 858-5492

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
4891CAMDMental Health Counselor
OP4891TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063597102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 DEERFIELD PL",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926791400",
            "telephone_number": "949-858-5492",
            "fax_number": "949-459-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12819 VALLEY VIEW AVE",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381945",
            "telephone_number": "562-921-6659",
            "fax_number": "562-921-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "MICHAEL",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OP4891T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.