NPIMap

Organization Active NPI

Blackstone Optometry

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1205174828
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12032T Issued in CA
Legal business name
BLACKSTONE OPTOMETRY
Practice address
2109 Hillhurst Ave
Los Angeles, CA 90027-2003
Phone
(323) 660-2020
Fax
(323) 660-2888
NPI assigned
Jan 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Authorized official

Name
Dr. Simon Cheng, O.D.NPI 1396887410
Title
Owner
Phone
(323) 660-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 12032T CA Primary

Addresses

Primary practice location

2109 Hillhurst Ave
Los Angeles, CA 90027-2003

Mailing address

2109 Hillhurst Ave
Los Angeles, CA 90027-2003
Phone (323) 660-2020

National Provider Directory

National Provider Directory

Locations

2109 Hillhurst Ave
Los Angeles, CA 90027
Phone (323) 660-2020

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1205174828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 HILLHURST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900272003",
            "telephone_number": "323-660-2020",
            "fax_number": "323-660-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 HILLHURST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900272003",
            "telephone_number": "323-660-2020",
            "fax_number": "323-660-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSTONE OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "CHENG",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-660-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12032T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.

Verify at the official NPI Registry.