NPIMap

Organization Active NPI

Suzan Burmayan, O.D., a Professional Corporation

  • Optometrist
  • San Dimas, CA
National Provider Identifier
1245077155
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SUZAN BURMAYAN, O.D., A PROFESSIONAL CORPORATION
Practice address
120 W Bonita Ave Ste a
San Dimas, CA 91773-5000
Phone
(909) 599-1100
NPI assigned
Jul 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Dr. Suzan Burmayan, ODNPI 1619498078
Title
Owner/Optometrist
Phone
(213) 507-3599

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 Primary

Addresses

Primary practice location

120 W Bonita Ave Ste a
San Dimas, CA 91773-5000

Mailing address

120 W Bonita Ave Ste a
San Dimas, CA 91773-5000
Phone (909) 599-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240912003721 CA Part B Supplier - Clinic/Group Practice 1456891712 Receives reassigned benefits from 2 practitioners
Practice locations: San Dimas, CA

National Provider Directory

National Provider Directory

Locations

120 W Bonita Ave
Ste A
San Dimas, CA 91773
Phone (909) 599-1100

Practitioners & affiliated clinicians

Practitioners 11

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": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1245077155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W BONITA AVE STE A",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917735000",
            "telephone_number": "909-599-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W BONITA AVE STE A",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917735000",
            "telephone_number": "909-599-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUZAN BURMAYAN, O.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "BURMAYAN",
        "authorized_official_first_name": "SUZAN",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "213-507-3599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.