Kolberg Ocular Products, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

KOLBERG OCULAR PRODUCTS, INC.

Practice address

9663 Tierra Grande St
Suite 201
San Diego, CA 92126-4568

Phone

(858) 695-2021

Fax

(858) 695-2712

NPI assigned

Jun 16, 2006

Last updated

Aug 22, 2020By 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

Gordon I Kolberg, B.C.O.

Title

President

Phone

(858) 695-2021

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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.

• Erik Kolberg, BCO

  • Ocularist
  • San Diego, CA
  • NPI 1912404609
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164466488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9663 TIERRA GRANDE ST",
            "address_2": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264568",
            "telephone_number": "858-695-2021",
            "fax_number": "858-695-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9663 TIERRA GRANDE ST",
            "address_2": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264568",
            "telephone_number": "858-695-2021",
            "fax_number": "858-695-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOLBERG OCULAR PRODUCTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOLBERG",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-695-2021",
        "authorized_official_credential": "B.C.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ33192Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amir Hossein Kolahdouz Isfahani, MD
• Matthew John Kolar
• Rahul Reddy Kolavala, M.D.
• Frederic Jerome Kolb, MD
• Mark Kolb, RN
• Erik Kolberg, BCO
• Rachel Kolden
• Rasa Lila Koletar
• Aryhk Imanuel Kolidakis
• Kolimpr'I LLC

• Prosthetic/Orthotic Supplier in San Diego, CA
• Providers in San Diego, CA by specialty
• Prosthetic/Orthotic Supplier in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.