Active NPI
Marc S. Simmons, O.D., Inc.
- Optometrist
- Los Angeles, CA
National Provider Identifier
1073555793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7057T
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0070570 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
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.