Active NPI
Michael Lawrence Byrne, O.D.
- Optometrist
- La Mirada, CA
National Provider Identifier
1063597102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OP4891T
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4891 | CA | MD | Mental Health Counselor |
| OP4891T | CA | MD | Optometrist |
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.