Active NPI
Edgar Alain Basto
- Optometrist
- Anaheim, CA
National Provider Identifier
1295879435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- D6662
- Practice address
- 1741 W Romneya Dr Ste D
Anaheim, CA 92801-1805 - Phone
- (714) 776-6692
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | D6662 | CA | Primary |
Addresses
Primary practice location
1741 W Romneya Dr Ste D
Anaheim, CA 92801-1805
Mailing address
256 San Joaquin St
Laguna Beach, CA 92651-1351
Phone (714) 776-6692
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DX006662F | Other | CA | MEDI-CAL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| D6662 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295879435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "256 SAN JOAQUIN ST",
"city": "LAGUNA BEACH",
"state": "CA",
"postal_code": "926511351",
"telephone_number": "714-776-6692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1741 W ROMNEYA DR STE D",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928011805",
"telephone_number": "714-776-6692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTO",
"first_name": "EDGAR",
"middle_name": "ALAIN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "D6662",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "DX006662F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.