John Celis, O.D., a Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

11704T Issued in CA

Legal business name

JOHN CELIS, O.D., A PROFESSIONAL CORPORATION

Doing business as

Lake Forest Family Eyecare

Practice address

23600 Rockfield Blvd
Suite 3F
Lake Forest, CA 92630-1624

Phone

(949) 206-1560

Fax

(949) 206-1655

NPI assigned

Oct 1, 2006

Last updated

Jan 23, 2015By 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

Dr. John Deguzman Celis, O.D.

Title

Owner/President

Phone

(949) 206-1560

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lake Forest Family Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Deguzman Celis, O.D.

  • Optometrist
  • Lake Forest, CA
  • NPI 1861542714
  Medicare reassignment NPD
• Jay E Rofsky, OD

  • Optometrist
  • Orange, CA
  • NPI 1104816933
  NPD (past)

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1144313412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23600 ROCKFIELD BLVD",
            "address_2": "SUITE 3F",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301624",
            "telephone_number": "949-206-1560",
            "fax_number": "949-206-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23600 ROCKFIELD BLVD",
            "address_2": "SUITE 3F",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301624",
            "telephone_number": "949-206-1560",
            "fax_number": "949-206-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN CELIS, O.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-01",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "CELIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DEGUZMAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "949-206-1560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11704T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2462134",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Forest Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Jimenez Saenz
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• John T. Eli, D.M.D., M.S.D., Inc.
• Kurt A Johnson
• Madison Johnson
• Tony Johnson
• Alexys Jordyn Jolstead

• Optometrist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.