Active NPI
Nelson & Endicott an Optometric Corporation
- Optometrist
- Rowland Heights, CA
National Provider Identifier
1134190853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6093T
- Legal business name
- NELSON & ENDICOTT AN OPTOMETRIC CORPORATION
- Practice address
- 19735 Colima Rd
Rowland Heights, CA 91748-3227 - Phone
- (626) 912-1536
- Fax
- (909) 468-4603
- NPI assigned
- Jan 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John C Nelson, O.D.
- Title
- Owner
- Phone
- (626) 912-1536
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6093T | CA | Primary |
Addresses
Primary practice location
19735 Colima Rd
Rowland Heights, CA 91748-3227
Mailing address
19735 Colima Rd
Rowland Heights, CA 91748-3227
Phone (626) 912-1536
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GSD001240 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
19735 Colima Rd
Rowland Heights, CA 91748
Phone (626) 912-1536
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Rowland Heights, CA
- NPI 1790795318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1343347200000",
"number": "1134190853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19735 COLIMA RD",
"city": "ROWLAND HEIGHTS",
"state": "CA",
"postal_code": "917483227",
"telephone_number": "626-912-1536",
"fax_number": "909-468-4603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19735 COLIMA RD",
"city": "ROWLAND HEIGHTS",
"state": "CA",
"postal_code": "917483227",
"telephone_number": "626-912-1536",
"fax_number": "909-468-4603"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NELSON & ENDICOTT AN OPTOMETRIC CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-30",
"last_updated": "2012-07-27",
"status": "A",
"authorized_official_last_name": "NELSON",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "626-912-1536",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "CA",
"license": "6093T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GSD001240",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rowland Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.