Dr. Douglas T. Munroe, an Optometrist Corp.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6298T Issued in CA

Legal business name

DR. DOUGLAS T. MUNROE, AN OPTOMETRIST CORP.

Practice address

464 S. Corona Mall
Corona, CA 92879-1418

Phone

(951) 737-3881

Fax

(951) 737-1530

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Douglas T. Munroe, OD

Title

Optometrist

Phone

(951) 737-3881

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1225185069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 S. CORONA MALL",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791418",
            "telephone_number": "951-737-3881",
            "fax_number": "951-737-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 S. CORONA MALL",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791418",
            "telephone_number": "951-737-3881",
            "fax_number": "951-737-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DOUGLAS T. MUNROE, AN OPTOMETRIST CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "MUNROE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "951-737-3881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6298T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INLAND EMPIRE HEALTH PLAN",
            "identifier": "11144",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES",
            "identifier": "06541",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED VISION CARE",
            "identifier": "211433",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET HMO",
            "identifier": "46237",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET PPO",
            "identifier": "48690",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6100714",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Corona, CA
• Providers in Corona, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.