Organization Active NPI

Old Towne Optometry, Inc.

  • Optometrist
  • Yorba Linda, CA
National Provider Identifier
1154812378
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10250-TLG Issued in CA
Legal business name
OLD TOWNE OPTOMETRY, INC.
Practice address
18291 Imperial Hwy
Yorba Linda, CA 92886-3408
Phone
(714) 777-1770
Fax
(714) 777-1292
NPI assigned
May 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Authorized official

Name
Laura Ashley Sherman
Title
Office Manager
Phone
(714) 777-1770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10250-TLG CA Primary

Addresses

Primary practice location

18291 Imperial Hwy
Yorba Linda, CA 92886-3408

Mailing address

18291 Imperial Hwy
Yorba Linda, CA 92886-3408
Phone (714) 777-1770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180808002743 CA Part B Supplier - Clinic/Group Practice 5496003329 Receives reassigned benefits from 3 practitioners
Practice locations: Yorba Linda, CA

National Provider Directory

National Provider Directory

Locations

18291 Imperial Hwy
Yorba Linda, CA 92886
Phone (714) 777-1770

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1154812378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18291 IMPERIAL HWY",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863408",
            "telephone_number": "714-777-1770",
            "fax_number": "714-777-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18291 IMPERIAL HWY",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863408",
            "telephone_number": "714-777-1770",
            "fax_number": "714-777-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWNE OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "SHERMAN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-777-1770"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10250-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.