Gary Bruce Myers, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

7998T Issued in CA

Practice address

1140 Main St Ste 207
Ramona, CA 92065-2168

Phone

(760) 789-1191

Fax

(760) 789-1216

NPI assigned

Jul 5, 2006

Last updated

Jan 15, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1093746620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 MAIN ST STE 207",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920652168",
            "telephone_number": "760-789-1191",
            "fax_number": "760-789-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 MAIN ST STE 207",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920652168",
            "telephone_number": "760-789-1191",
            "fax_number": "760-789-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "GARY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7998T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0079980",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OP7998",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Jean Morgan, PT
• Jennifer Mraovic, DACM
• Deepti Sameer Mundkur, MBBS
• Tate Murphy
• Dante Jamone Murry II
• Zinah Nakarah, RPH
• Aws Nassir
• Anna Louise Nelson, LMFT
• Ashley Eileen Nelson
• Stacey Nelson, MS, OT

• Optometrist in Ramona, CA
• Providers in Ramona, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.