Robert J. Graham O.D. Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP8729 Issued in CA

Legal business name

ROBERT J. GRAHAM O.D. INC

Practice address

635 E Ojai Ave
Ojai, CA 93023-2822

Phone

(805) 646-8510

Fax

(805) 646-2968

NPI assigned

Jan 11, 2013

Organization subpart

No

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

Authorized official

Name

Robert Jackson Graham, O.D.NPI 1750365052

Title

President

Phone

(805) 646-8510

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Robert Jackson Graham, OD

  • Optometrist
  • Ojai, CA
  • NPI 1750365052
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1174860001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880",
            "city": "OJAI",
            "state": "CA",
            "postal_code": "930240880",
            "telephone_number": "805-646-8510",
            "fax_number": "805-646-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 E OJAI AVE",
            "city": "OJAI",
            "state": "CA",
            "postal_code": "930232822",
            "telephone_number": "805-646-8510",
            "fax_number": "805-646-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J. GRAHAM O.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-646-8510",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OP8729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD00872901",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Ojai, CA
• Providers in Ojai, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.