NPIMap

Organization Active NPI

San Diego Optical

  • Optician
  • La Jolla, CA
National Provider Identifier
1154537066
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
D621 Issued in CA
Legal business name
SAN DIEGO OPTICAL
Practice address
7701 Fay Ave
La Jolla, CA 92037-4310
Phone
(858) 454-0033
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carter Shrum
Title
Owner
Phone
(858) 454-0033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X D621 CA Primary

Addresses

Primary practice location

7701 Fay Ave
La Jolla, CA 92037-4310

Mailing address

7701 Fay Ave
La Jolla, CA 92037-4310
Phone (858) 454-0033

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154537066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 FAY AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374310",
            "telephone_number": "858-454-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 FAY AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374310",
            "telephone_number": "858-454-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHRUM",
        "authorized_official_first_name": "CARTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-454-0033"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "D621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.