Individual provider Active NPI

Anthony J Sardonia, O.D.

  • Optometrist
  • Valencia, CA
National Provider Identifier
1255529749
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6341T Issued in CA
Practice address
23861 McBean Pkwy
E-12
Valencia, CA 91355-2058
Phone
(661) 259-6022
Fax
(661) 259-9742
NPI assigned
Oct 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6341T CA Primary

Addresses

Primary practice location

23861 McBean Pkwy
E-12
Valencia, CA 91355-2058

Mailing address

23861 McBean Pkwy
E-12
Valencia, CA 91355-2058
Phone (661) 259-6022

Other identifiers 1

IdentifierTypeStateIssuer
6341TOtherCAPROFESSIONAL LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6341TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1255529749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23861 MCBEAN PKWY",
            "address_2": "E-12",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552058",
            "telephone_number": "661-259-6022",
            "fax_number": "661-259-9742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23861 MCBEAN PKWY",
            "address_2": "E-12",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552058",
            "telephone_number": "661-259-6022",
            "fax_number": "661-259-9742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARDONIA",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6341T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE #",
            "identifier": "6341T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.