Paul Mikailian an Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

14631TLG Issued in CA

Legal business name

PAUL MIKAILIAN AN OPTOMETRIC CORPORATION

Practice address

26471 Carl Boyer Dr
Santa Clarita, CA 91350-2996

Phone

(661) 288-2068

NPI assigned

Apr 18, 2018

Last updated

Apr 18, 2018By 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

Paul Leon Mikailan, OD

Title

Owner

Phone

(818) 913-5113

Specialties & licenses 1

Addresses

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.

• Paul Leon Mikailian, O.D.

  • Optometrist
  • Santa Clarita, CA
  • NPI 1366880460
  Medicare reassignment

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1093202723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10727 RUSSETT AVE",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "910402306",
            "telephone_number": "818-913-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26471 CARL BOYER DR",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502996",
            "telephone_number": "661-288-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL MIKAILIAN AN OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "MIKAILAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-913-5113",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14631TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.