NPIMap

Organization Active NPI

Loran Bruce Mebine

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1275694531
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4991T Issued in CA
Legal business name
LORAN BRUCE MEBINE
Practice address
340 W Portal Ave
San Francisco, CA 94127-1412
Phone
(415) 664-3089
Fax
(415) 564-3072
NPI assigned
Dec 12, 2006
Last updated
Sep 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Marilyn Overbay
Title
Office Manager
Phone
(415) 664-3089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4991T CA Primary

Addresses

Primary practice location

340 W Portal Ave
San Francisco, CA 94127-1412

Mailing address

340 W Portal Ave
San Francisco, CA 94127-1412
Phone (415) 664-3089

Other identifiers 1

IdentifierTypeStateIssuer
GSDOOO160MedicaidCA

National Provider Directory

National Provider Directory

Locations

340 West Portal Ave
San Francisco, CA 94127
Phone (415) 664-3089

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1275694531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W PORTAL AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271412",
            "telephone_number": "415-664-3089",
            "fax_number": "415-564-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W PORTAL AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271412",
            "telephone_number": "415-664-3089",
            "fax_number": "415-564-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORAN BRUCE MEBINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "OVERBAY",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "415-664-3089"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "4991T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSDOOO160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.