Walnut Creek Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

050143 Issued in CA

Legal business name

WALNUT CREEK OPTICAL

Practice address

1988 Tice Valley Blvd
Walnut Creek, CA 94595-2203

Phone

(925) 925-6650

Fax

(925) 935-6686

NPI assigned

Feb 14, 2012

Organization subpart

No

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

Authorized official

Name

Mark Drucker, M.D.NPI 1699753046

Title

Partner

Phone

(925) 935-8822

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Walnut Creek Optical at Rossmoor Other name

Locations

Practitioners 2

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

• Mark Drucker, MD

  • Ophthalmology Physician
  • Walnut Creek, CA
  • NPI 1699753046
  NPD (past) Authorized official
• Joseph F Barakeh, DO PHD

  • Ophthalmology Physician
  • Walnut Creek, CA
  • NPI 1013990613
  NPD

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1205109766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 SAN MIGUEL DR",
            "address_2": "SUITE 28",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965279",
            "telephone_number": "925-935-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1988 TICE VALLEY BLVD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952203",
            "telephone_number": "925-925-6650",
            "fax_number": "925-935-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT CREEK OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "DRUCKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "925-935-8822",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "050143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0848850001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walnut Creek Optical at Rossmoor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Eyewear Supplier in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.