Active NPI
Samuel Victor Stella, O.D.
- Optometrist
- Huntington Beach, CA
National Provider Identifier
1275635179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5214T
- Practice address
- 15057 Goldenwest St
Huntington Beach, CA 92647-2710 - Phone
- (714) 894-5556
- Fax
- (714) 895-3126
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5214T | CA | Primary |
Addresses
Primary practice location
15057 Goldenwest St
Huntington Beach, CA 92647-2710
Mailing address
15057 Goldenwest St
Huntington Beach, CA 92647-2710
Phone (714) 894-5556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0052140 | Other | CA | BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5214 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189468800000",
"number": "1275635179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15057 GOLDENWEST ST",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926472710",
"telephone_number": "714-894-5556",
"fax_number": "714-895-3126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15057 GOLDENWEST ST",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926472710",
"telephone_number": "714-894-5556",
"fax_number": "714-895-3126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STELLA",
"first_name": "SAMUEL",
"middle_name": "VICTOR",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2007-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5214T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "SD0052140",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.