South Gate Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

9996T Issued in CA

Legal business name

SOUTH GATE OPTOMETRY INC

Practice address

3329 Tweedy Blvd
South Gate, CA 90280-4324

Phone

(323) 566-6183

NPI assigned

Aug 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Anna M Pennino, O.D.

Title

Owner

Phone

(323) 566-6183

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235001600000",
    "number": "1154514370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3329 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902804324",
            "telephone_number": "323-566-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3329 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902804324",
            "telephone_number": "323-566-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GATE OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2009-02-19",
        "status": "A",
        "authorized_official_last_name": "PENNINO",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-566-6183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9996T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0099960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonia Canton Moran DDS a Dental Corporation
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• South Gate Optometry
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• Aruna Sridharan
• St. Francis Medical Center

• Optometrist in South Gate, CA
• Providers in South Gate, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.