Individual provider Active NPI

Jilber Fouladian, O.D.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1174669873
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12294T Issued in CA
Practice address
1312 Westwood Blvd
Los Angeles, CA 90024-4902
Phone
(310) 234-8900
Fax
(310) 388-0188
NPI assigned
Jan 29, 2007
Last updated
Jun 22, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12294T CA Primary

Addresses

Primary practice location

1312 Westwood Blvd
Los Angeles, CA 90024-4902

Mailing address

1312 Westwood Blvd
Los Angeles, CA 90024-4902
Phone (310) 709-4373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040130001075 CA Practitioner - Optometry 7911800404 Practice locations: Los Angeles, CA; Montrose, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1312 Westwood Blvd
Los Angeles, CA 90024-4902
Phone (310) 234-8900

2490 Honolulu Ave
Suite 140B
Montrose, CA 91020-1800
Phone (818) 330-7555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12294TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc. Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1174669873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 WESTWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244902",
            "telephone_number": "310-709-4373",
            "fax_number": "310-388-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 WESTWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244902",
            "telephone_number": "310-234-8900",
            "fax_number": "310-388-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOULADIAN",
        "first_name": "JILBER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12294T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.