Organization Active NPI

Dr. Joseph'S Eye Medical Clinic, Inc.

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1306066089
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G38640 Issued in CA
Legal business name
DR. JOSEPH'S EYE MEDICAL CLINIC, INC.
Practice address
1211 N Vermont Ave
# 200
Los Angeles, CA 90029-1748
Phone
(323) 663-3333
Fax
(323) 661-1197
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Authorized official

Name
Joseph Eshagian, M.D.
Title
President
Phone
(323) 663-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G38640 CA Primary

Addresses

Primary practice location

1211 N Vermont Ave
# 200
Los Angeles, CA 90029-1748

Mailing address

1211 N Vermont Ave
# 200
Los Angeles, CA 90029-1748
Phone (323) 663-3333

Other identifiers 1

IdentifierTypeStateIssuer
00G386400MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100623000264 CA Part B Supplier - Clinic/Group Practice 4981735701 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1211 N Vermont Ave
Ste 200
Los Angeles, CA 90029
Phone (323) 663-3333

Practitioners & affiliated clinicians

Practitioners 1

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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1306066089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 N VERMONT AVE",
            "address_2": "# 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291748",
            "telephone_number": "323-663-3333",
            "fax_number": "323-661-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 N VERMONT AVE",
            "address_2": "# 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291748",
            "telephone_number": "323-663-3333",
            "fax_number": "323-661-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOSEPH'S EYE MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "ESHAGIAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-663-3333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G38640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G386400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.