Active NPI
Paul Seidel, OD
- Optometrist
- Pasadena, CA
National Provider Identifier
1114096336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- CA5943T
- Practice address
- 477 E Colorado Blvd
Pasadena, CA 91101 - Phone
- (626) 796-1191
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | CA5943T | CA | Primary |
Addresses
Primary practice location
477 E Colorado Blvd
Pasadena, CA 91101
Mailing address
477 E Colorado Blvd
Pasadena, CA 91101-2024
Phone (626) 796-1191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0059430 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59435 | CA | MD | General Practice Dentistry |
| CA5943T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Arlene T. Yepremian, O.D. a Professional Corporation | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Glendale, CA
- NPI 1043547482
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1114096336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "477 E COLORADO BLVD",
"city": "PASADENA",
"state": "CA",
"postal_code": "911012024",
"telephone_number": "626-796-1191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "477 E COLORADO BLVD",
"city": "PASADENA",
"state": "CA",
"postal_code": "91101",
"telephone_number": "626-796-1191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEIDEL",
"first_name": "PAUL",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "CA5943T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0059430",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.