NPIMap

Organization Active NPI

Costco Wholesale Corporation

  • Eyewear Supplier
  • Tustin, CA
National Provider Identifier
1154710002
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
D5895 Issued in CA
Legal business name
COSTCO WHOLESALE CORPORATION
Practice address
2655 El Camino Real
Tustin, CA 92782-8918
Phone
(714) 838-0498
Fax
(714) 838-7082
NPI assigned
Jan 15, 2015
Organization subpart
Yes
Parent organization
COSTCO WHOLESALE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Art Salas
Title
Avp Optical
Phone
(714) 838-0498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X D5895 CA Primary

Addresses

Primary practice location

2655 El Camino Real
Tustin, CA 92782-8918

Mailing address

PO Box 35005
Seattle, WA 98124-3405
Phone (425) 313-8100

Other names 1

  • Costco Optical #122 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy 3021,506 organizations share this tax ID, including this one
Part of
Costco Pharmacy 302

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2655 El Camino Real
Tustin, CA 92782
Phone (714) 592-3222

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1154710002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35005",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243405",
            "telephone_number": "425-313-8100",
            "fax_number": "425-313-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 EL CAMINO REAL",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927828918",
            "telephone_number": "714-838-0498",
            "fax_number": "714-838-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSTCO WHOLESALE CORPORATION",
        "enumeration_date": "2015-01-15",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "ART",
        "authorized_official_title_or_position": "AVP OPTICAL",
        "authorized_official_telephone_number": "714-838-0498"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "D5895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Optical #122",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Costco Optical #122",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.