Individual provider Active NPI

Milton Mitsuyoshi Tari, O.D.

  • Optometrist
  • Santa Monica, CA
National Provider Identifier
1124179254
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9370T Issued in CA
Practice address
195 Santa Monica PL
#195
Santa Monica, CA 90401-2364
Phone
(310) 576-6023
Fax
(310) 393-3883
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9370T CA Primary

Addresses

Primary practice location

195 Santa Monica PL
#195
Santa Monica, CA 90401-2364

Mailing address

192 Fox Hills Mall
C O Eyexam
Culver City, CA 90230-6402
Phone (310) 329-7147

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

LicenseStateTypeSpecialty
9370TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124179254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 FOX HILLS MALL",
            "address_2": "C O EYEXAM",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306402",
            "telephone_number": "310-329-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 SANTA MONICA PL",
            "address_2": "#195",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012364",
            "telephone_number": "310-576-6023",
            "fax_number": "310-393-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARI",
        "first_name": "MILTON",
        "middle_name": "MITSUYOSHI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9370T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.