Gary M Lazarus OD PHD Apc

Primary specialty

OptometristTaxonomy code 152W00000X

License

5171T Issued in CA

Legal business name

GARY M LAZARUS OD PHD APC

Practice address

806 Manhattan Beach Blvd
Suite 103
Manhattan Beach, CA 90266-4960

Phone

(310) 372-2197

Fax

(310) 372-6581

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Gary Marc Lazarus, OD

Title

Optometrist Owner

Phone

(310) 372-2197

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Gary M Lazarus OD or Gary M Lazarus OD Phd FAAD Other name

Locations

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1083789366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 MANHATTAN BEACH BLVD",
            "address_2": "SUITE 103",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902664960",
            "telephone_number": "310-372-2197",
            "fax_number": "310-372-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 MANHATTAN BEACH BLVD",
            "address_2": "SUITE 103",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902664960",
            "telephone_number": "310-372-2197",
            "fax_number": "310-372-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY M LAZARUS OD PHD APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "LAZARUS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "OPTOMETRIST  OWNER",
        "authorized_official_telephone_number": "310-372-2197",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5171T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHILE OF CA",
            "identifier": "SD0051710",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32660VE",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0051710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gary M Lazarus OD or Gary M Lazarus OD Phd FAAD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Optometrist in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.