Campbell Optometric Group

Primary specialty

OptometristTaxonomy code 152W00000X

License

5902T Issued in CA

Legal business name

CAMPBELL OPTOMETRIC GROUP

Practice address

621 E Campbell Ave Ste 11B
Campbell, CA 95008-2136

Phone

(408) 378-4661

Fax

(408) 378-6160

NPI assigned

Oct 22, 2008

Last updated

Oct 23, 2008By 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

Sherry Gould

Title

Office Mananger

Phone

(408) 378-4661

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1114179009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 E CAMPBELL AVE STE 11B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082136",
            "telephone_number": "408-378-4661",
            "fax_number": "408-378-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E CAMPBELL AVE STE 11B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082136",
            "telephone_number": "408-378-4661",
            "fax_number": "408-378-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL OPTOMETRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "OFFICE MANANGER",
        "authorized_official_telephone_number": "408-378-4661"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5902T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY49157Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camden Pharmacy
• Camden Postacute Care, Inc.
• Melissa Jean Cameron, O.T.
• Campbell Medicals LLC
• Campbell Optometric Group (same as above)
• Campbell Surgery Center
• Campbell Teen & Family Therapy
• Campbell Union School District
• Gabrielle Campbell
• Campbell's Premier Physical Therapy, Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.