Individual provider Active NPI

Cecilia Yvonne Perez, O.D

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1093870453
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10219T Issued in CA
Practice address
1149 S Hill St
365
Los Angeles, CA 90015-2212
Phone
(213) 749-3461
Fax
(213) 749-1618
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10219T CA Primary

Addresses

Primary practice location

1149 S Hill St
365
Los Angeles, CA 90015-2212

Mailing address

1149 S Hill St
365
Los Angeles, CA 90015-2212
Phone (213) 749-3461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070321000364 CA Practitioner - Optometry 8325141864 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10219TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1093870453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 S HILL ST",
            "address_2": "365",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152212",
            "telephone_number": "213-749-3461",
            "fax_number": "213-749-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 S HILL ST",
            "address_2": "365",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152212",
            "telephone_number": "213-749-3461",
            "fax_number": "213-749-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CECILIA",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10219T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.