NPIMap

Organization Active NPI

Wolstan & Goldberg Eye Associates Inc a Medical Corporaton

  • Ophthalmology Physician
  • Torrance, CA
National Provider Identifier
1285860445
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WOLSTAN & GOLDBERG EYE ASSOCIATES INC A MEDICAL CORPORATON
Practice address
23600 Telo Ave
Suite 100
Torrance, CA 90505-4035
Phone
(310) 543-2611
Fax
(310) 543-2056
NPI assigned
Jun 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Authorized official

Name
Dr. Barry James Wolstan, M.D.NPI 1568407377
Title
Owner
Phone
(310) 543-2611

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

23600 Telo Ave
Suite 100
Torrance, CA 90505-4035

Mailing address

23600 Telo Ave
Suite 100
Torrance, CA 90505-4035
Phone (310) 543-2611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100415000069 CA Part B Supplier - Clinic/Group Practice 9234266776 Receives reassigned benefits from 7 practitioners
Practice locations: Torrance, CA

National Provider Directory

National Provider Directory
Tax ID family
Barry J Wolstan M D Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 7

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": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1285860445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23600 TELO AVE",
            "address_2": "SUITE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054035",
            "telephone_number": "310-543-2611",
            "fax_number": "310-543-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23600 TELO AVE",
            "address_2": "SUITE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054035",
            "telephone_number": "310-543-2611",
            "fax_number": "310-543-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLSTAN & GOLDBERG EYE ASSOCIATES INC A MEDICAL CORPORATON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "WOLSTAN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-543-2611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.