Efrain Mascareno OD Apc

Primary specialty

OptometristTaxonomy code 152W00000X

License

10906T Issued in CA

Legal business name

EFRAIN MASCARENO OD APC

Doing business as

Clear Vision Optometry

Practice address

440 4TH Ave
Chula Vista, CA 91910-4443

Phone

(619) 427-2020

Fax

(866) 254-5707

NPI assigned

Nov 20, 2006

Last updated

Apr 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Efrain Mascareno, ODNPI 1457507279

Title

President

Phone

(619) 427-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clear Vision Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Efrain Mascareno, O.D.

  • Optometrist
  • Chula Vista, CA
  • NPI 1457507279
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1073687851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 4TH AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104443",
            "telephone_number": "619-427-2020",
            "fax_number": "866-254-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 4TH AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104443",
            "telephone_number": "619-427-2020",
            "fax_number": "866-254-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFRAIN MASCARENO OD APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "MASCARENO",
        "authorized_official_first_name": "EFRAIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-427-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10906T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0109061",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Vision Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.