Individual provider Active NPI

Vida L Arjomand, O.D.

  • Optometrist
  • Santa Ana, CA
National Provider Identifier
1114011103
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10226T Issued in CA
Practice address
2800 N Main St
Santa Ana, CA 92705-6607
Phone
(714) 547-8129
Fax
(714) 547-5626
NPI assigned
Oct 3, 2006
Last updated
Jul 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10226T CA Primary

Addresses

Primary practice location

2800 N Main St
Santa Ana, CA 92705-6607

Mailing address

330 N Brand Blvd Ste 110
Glendale, CA 91203-2308
Phone (818) 240-0890

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
I20060105000798 CA Practitioner - Optometry 0143243022

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10226TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare Professional Optometric Group Optometrist CurrentSince Aug 1, 2011 Accepting new patients
Pearle Visioncare, Inc Optometrist Past Accepting new patients
Pearle Visioncare, Inc Optometrist Past Accepting new patients
Pearle Visioncare, Inc Past Accepting new patients
Pearle Visioncare Inc Optometrist Past Accepting new patients

Locations

330 N Brand Blvd
Ste 110
Glendale, CA 91203
Phone (818) 240-0890

1055 Foothill Blvd
La Canada, CA 91011

6702 Inglewood Ave
Ste H
Stockton, CA 95207
Phone (209) 951-3937

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1114011103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N BRAND BLVD STE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032308",
            "telephone_number": "818-240-0890",
            "fax_number": "818-246-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056607",
            "telephone_number": "714-547-8129",
            "fax_number": "714-547-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARJOMAND",
        "first_name": "VIDA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10226T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.