NPIMap

Organization Active NPI

Larry J Gottlieb Inc a Professional Corporation

  • Optometrist
  • Lakewood, CA
National Provider Identifier
1235537119
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6451T Issued in CA
Legal business name
LARRY J GOTTLIEB INC A PROFESSIONAL CORPORATION
Practice address
6418 Del Amo Blvd
Lakewood, CA 90713-2204
Phone
(562) 420-2055
Fax
(562) 420-1784
NPI assigned
Dec 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Authorized official

Name
Dr. Larry Jay Gottlieb, ODNPI 1609900653
Title
President
Phone
(714) 488-5472

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 6451T CA Primary

Addresses

Primary practice location

6418 Del Amo Blvd
Lakewood, CA 90713-2204

Mailing address

6418 Del Amo Blvd
Lakewood, CA 90713-2204
Phone (562) 420-2055

Other names 1

  • Dr Larry J Gottlieb OD Inc Other name

National Provider Directory

National Provider Directory
Tax ID family
Dr Gottlieb Optometry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6418 Del Amo Blvd
Lakewood, CA 90713
Phone (562) 420-2055

Practitioners & affiliated clinicians

Practitioners 6

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": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1235537119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 DEL AMO BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907132204",
            "telephone_number": "562-420-2055",
            "fax_number": "562-420-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 DEL AMO BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907132204",
            "telephone_number": "562-420-2055",
            "fax_number": "562-420-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY J GOTTLIEB INC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "GOTTLIEB",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-488-5472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6451T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Larry J Gottlieb OD Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.