Active NPI
Stanley S Mestman, O.D.
- Optometrist
- San Diego, CA
National Provider Identifier
1184734071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT5567
- Practice address
- 3075 Health Center Dr
Suite 401
San Diego, CA 92123-2773 - Phone
- (858) 939-5400
- Fax
- (858) 939-5419
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT5567 | CA | Primary |
Addresses
Primary practice location
3075 Health Center Dr
Suite 401
San Diego, CA 92123-2773
Mailing address
3075 Health Center Dr
Suite 401
San Diego, CA 92123-2773
Phone (858) 939-5400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0055670 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OPT5567 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1184734071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3075 HEALTH CENTER DR",
"address_2": "SUITE 401",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232773",
"telephone_number": "858-939-5400",
"fax_number": "858-939-5419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3075 HEALTH CENTER DR",
"address_2": "SUITE 401",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232773",
"telephone_number": "858-939-5400",
"fax_number": "858-939-5419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MESTMAN",
"first_name": "STANLEY",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT5567",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0055670",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.