Dr. Taylor Bladh O.D. Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT8921TPA Issued in CA

Legal business name

DR. TAYLOR BLADH O.D. INC

Practice address

16481 Magnolia St
Westminster, CA 92683-7827

Phone

(714) 848-0028

Fax

(714) 842-0160

NPI assigned

Nov 7, 2014

Organization subpart

No

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

Authorized official

Name

Taylor Bladh

Title

Owner

Phone

(714) 848-0028

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Dr Taylor Bladh OD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dr. Taylor Bladh O.D. Inc

  • Optometrist
  • Costa Mesa, CA
  • NPI 1700440633
  NPD tax ID

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1124424809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16481 MAGNOLIA ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926837827",
            "telephone_number": "714-848-0028",
            "fax_number": "714-842-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16481 MAGNOLIA ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926837827",
            "telephone_number": "714-848-0028",
            "fax_number": "714-842-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. TAYLOR BLADH O.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "BLADH",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-848-0028"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8921TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0088870",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0081970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; 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.