NPIMap

Organization Active NPI

San Pedro Eye Medical Group, Inc a Professional Medical Corporation

Doing business as San Pedro Eye Care

  • Optometrist
  • San Pedro, CA
National Provider Identifier
1235168055
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7967 Issued in CA
Legal business name
SAN PEDRO EYE MEDICAL GROUP, INC A PROFESSIONAL MEDICAL CORPORATION
Doing business as
San Pedro Eye Care
Practice address
571 W 7TH St
San Pedro, CA 90731-3115
Phone
(310) 833-1327
Fax
(310) 833-0698
NPI assigned
Jul 2, 2006
Last updated
Dec 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Authorized official

Name
Dr. Gene David Calkins, O.D.NPI 1568425569
Title
Owner/Partner
Phone
(310) 833-1327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4919 CA
Optometrist 152W00000X 7967 CA Primary
Specialist 174400000X G14368 CA

Addresses

Primary practice location

571 W 7TH St
San Pedro, CA 90731-3115

Mailing address

571 W 7TH St
San Pedro, CA 90731-3115
Phone (310) 833-1327

Other names 1

  • San Pedro Eye Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1235168055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313115",
            "telephone_number": "310-833-1327",
            "fax_number": "310-833-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313115",
            "telephone_number": "310-833-1327",
            "fax_number": "310-833-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN PEDRO EYE MEDICAL GROUP, INC A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "CALKINS",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "310-833-1327",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "4919",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7967",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G14368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Pedro Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Pedro Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.