Organization Active NPI

Mark Kislinger M.D., Inc.

  • Ophthalmology Physician
  • Glendora, CA
National Provider Identifier
1215089594
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MARK KISLINGER M.D., INC.
Practice address
210 S Grand Ave
Suite 106
Glendora, CA 91741
Phone
(626) 335-0535
Fax
(626) 914-7664
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Authorized official

Name
Monica Sivelle
Title
Operations Manager
Phone
(626) 335-0535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

210 S Grand Ave
Suite 106
Glendora, CA 91741

Mailing address

210 S Grand Ave
Suite 106
Glendora, CA 91741-4205
Phone (626) 335-0535

Other practice location 1

2619 E Colorado Blvd Ste 100
Pasadena, CA 91107-3747
Phone (626) 793-3475

Other practice location 2

1135 S Sunset Ave Ste 304
West Covina, CA 91790-3921
Phone (626) 335-0535

Other identifiers 1

IdentifierTypeStateIssuer
00A409621MedicaidCA

Other names 1

  • Foothill Eye Care Services Doing business as

National Provider Directory

National Provider Directory

Locations

234 S 1st Ave
#101
Arcadia, CA 91006

7 W Foothill Blvd
Ste A
Arcadia, CA 91006
Phone (626) 795-3453

14335 Pipeline Ave
Ste A
Chino, CA 91710

409 E Arrow Hwy
Glendora, CA 91740
Phone (626) 914-2414

210 S Grand Ave
Glendora, CA 91741
Phone (626) 335-0213

2421 W Beverly Blvd
Montebello, CA 90640
Phone (323) 888-9111

515 W Beverly Blvd
Ste 101
Montebello, CA 90640

2619 E Colorado Blvd
#100
Pasadena, CA 91107
Phone (626) 793-3475

541 W Valley Blvd
San Gabriel, CA 91776
Phone (626) 289-8868

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1215089594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "SUITE 106",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414205",
            "telephone_number": "626-335-0535",
            "fax_number": "626-914-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "SUITE 106",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91741",
            "telephone_number": "626-335-0535",
            "fax_number": "626-914-7664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2619 E Colorado Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911073747",
            "country_code": "US",
            "telephone_number": "626-793-3475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1135 S Sunset Ave Ste 304",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917903921",
            "country_code": "US",
            "telephone_number": "626-335-0535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARK KISLINGER M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "SIVELLE",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "626-335-0535"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A409621",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothill Eye Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.