Organization Active NPI

Marc S. Simmons, O.D., Inc.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1073555793
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7057T Issued in CA
Legal business name
MARC S. SIMMONS, O.D., INC.
Practice address
6225 W 87TH St
Suite 101
Los Angeles, CA 90045-3979
Phone
(310) 674-5123
Fax
(310) 674-1966
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Authorized official

Name
Dr. Marc S. Simmons, O.D.
Title
President
Phone
(310) 674-5123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 7057T CA Primary

Addresses

Primary practice location

6225 W 87TH St
Suite 101
Los Angeles, CA 90045-3979

Mailing address

6225 W 87TH St
Suite 101
Los Angeles, CA 90045-3979
Phone (310) 674-5123

Other identifiers 1

IdentifierTypeStateIssuer
SD0070570MedicaidCA

National Provider Directory

National Provider Directory

Locations

105 N Market St
Inglewood, CA 90301
Phone (310) 674-5123

6225 W 87th St
Ste 101
Los Angeles, CA 90045
Phone (310) 674-5123

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1073555793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 W 87TH ST",
            "address_2": "SUITE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453979",
            "telephone_number": "310-674-5123",
            "fax_number": "310-674-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 W 87TH ST",
            "address_2": "SUITE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453979",
            "telephone_number": "310-674-5123",
            "fax_number": "310-674-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC S. SIMMONS, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-674-5123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7057T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0070570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.