NPIMap

Organization Active NPI

Bonita Point Family Optometry, Inc.

  • Optometrist
  • Bonita, CA
National Provider Identifier
1265637714
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7989TPL Issued in CA
Legal business name
BONITA POINT FAMILY OPTOMETRY, INC.
Practice address
180 Otay Lakes Rd
Suite 201
Bonita, CA 91902-2443
Phone
(619) 267-9900
Fax
(619) 267-9910
NPI assigned
Jun 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Dr. Daniel Luther Mason, OD
Title
President
Phone
(619) 267-9900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 7989TPL CA Primary

Addresses

Primary practice location

180 Otay Lakes Rd
Suite 201
Bonita, CA 91902-2443

Mailing address

180 Otay Lakes Rd
Suite 201
Bonita, CA 91902-2443
Phone (619) 267-9900

Other identifiers 3

IdentifierTypeStateIssuer
1841406394OtherNPI
SD0079890MedicaidCA
1841208840OtherCANPI

National Provider Directory

National Provider Directory

Locations

180 Otay Lakes Rd
Ste 201
Bonita, CA 91902
Phone (619) 267-2012

746 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 475-2200

Practitioners & affiliated clinicians

Practitioners 8

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": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1265637714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 OTAY LAKES RD",
            "address_2": "SUITE 201",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919022443",
            "telephone_number": "619-267-9900",
            "fax_number": "619-267-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 OTAY LAKES RD",
            "address_2": "SUITE 201",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919022443",
            "telephone_number": "619-267-9900",
            "fax_number": "619-267-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONITA POINT FAMILY OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "LUTHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-267-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7989TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841406394",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0079890",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841208840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.