Walter R. Wolleat, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP5349T Issued in CA

Practice address

28356 S Western Ave
Rancho Palos Verdes, CA 90275-1434

Phone

(310) 831-0841

Fax

(310) 831-3369

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1205947603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28356 S WESTERN AVE",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751434",
            "telephone_number": "310-831-0841",
            "fax_number": "310-831-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28356 S WESTERN AVE",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751434",
            "telephone_number": "310-831-0841",
            "fax_number": "310-831-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLEAT",
        "first_name": "WALTER",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OP5349T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0409420-001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Richard White, M.D.
• Wickett Behavioral Solutions
• Corinne E.D. Wickett
• Frederick D Williams, M.D.
• George Wissa, PHARMD
• Mary Jo Wolowicz, MFT
• Cindy Chunchung Wong, RPH
• Cheryl Ann Woodson, D.P.T.
• Krystle Wright
• Louis Wu, RD

• Optometrist in Rancho Palos Verdes, CA
• Providers in Rancho Palos Verdes, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.