Antelope Valley Family Optometry, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

11428T Issued in CA

Legal business name

ANTELOPE VALLEY FAMILY OPTOMETRY, INC

Practice address

2720 E Palmdale Blvd Ste 133
Palmdale, CA 93550-4930

Phone

(661) 267-0026

Fax

(661) 267-0892

NPI assigned

May 11, 2006

Organization subpart

No

Name

Dr. Paul Lin, O.D.NPI 1710956016

Title

President

Phone

(661) 267-0026

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Antelope Valley Family Optometry, Inc

  • Optometrist
  • Valencia, CA
  • NPI 1427230465

  O20061004000384

  Same enrollment

Organizations that report the same tax identification number in the National Provider Directory.

• Antelope Valley Family Optometry, Inc

  • Optometrist
  • Valencia, CA
  • NPI 1427230465
  NPD tax ID

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Lin, O.D.

  • Optometrist
  • Palmdale, CA
  • NPI 1710956016
  NPD Authorized official
• Allison Marie Coffie, O.D.

  • Optometrist
  • Palmdale, CA
  • NPI 1396151726
  NPD

Medicare fee-for-service enrollment

Enrolled in CA

Tax ID family

Antelope Valley Family Optometry Inc (2 organizations share this tax ID)

• Antelope Valley Family Optometry Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 25, 2018.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529884800000",
    "number": "1073563706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 E PALMDALE BLVD",
            "address_2": "SUITE 133",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504930",
            "telephone_number": "661-267-0026",
            "fax_number": "661-267-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 E PALMDALE BLVD STE 133",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504930",
            "telephone_number": "661-267-0026",
            "fax_number": "661-267-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTELOPE VALLEY FAMILY OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2018-06-25",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-267-0026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11428T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6204141",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Antelope Valley Family Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Antelope Valley Family Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Antelope Hospice Corporation
• Antelope Valley Assisted Living LLC
• Antelope Valley Community Clinic
• Antelope Valley Community Clinic
• Antelope Valley Community Clinic
• Antelope Valley Home Health Agency Inc.
• Antelope Valley Hospital OB Clinic Palmdale
• Antelope Valley Impotence & Incontinence Medical Center, Inc
• Antelope Valley Lung & Sleep Institute, Inc
• Antelope Valley Outpatient Imaging Center, LLC

• All providers in Palmdale, CA
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.