Individual provider Active NPI

Darcy Calvin Ryan, O.D.

  • Optometrist
  • Long Beach, CA
National Provider Identifier
1184690950
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11208TPL Issued in CA
Practice address
2977 Redondo Ave
Long Beach, CA 90806-2445
Phone
(562) 595-4366
Fax
(562) 595-6092
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11208TPL CA Primary

Addresses

Primary practice location

2977 Redondo Ave
Long Beach, CA 90806-2445

Mailing address

2977 Redondo Ave
Long Beach, CA 90806-2445
Phone (562) 595-4366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11208TPLCAMDOptometrist
11280CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1184690950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2977 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062445",
            "telephone_number": "562-595-4366",
            "fax_number": "562-595-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2977 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062445",
            "telephone_number": "562-595-4366",
            "fax_number": "562-595-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "DARCY",
        "middle_name": "CALVIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11208TPL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.