Organization Active NPI

Deval Patel Optometric Corporation

  • Optometrist
  • West Covina, CA
National Provider Identifier
1306402508
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DEVAL PATEL OPTOMETRIC CORPORATION
Practice address
2225 E Garvey Ave N
West Covina, CA 91791-1500
Phone
(626) 966-3033
NPI assigned
May 13, 2019
Last updated
May 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Authorized official

Name
Ms. Erica Perreira
Title
Coo
Phone
(707) 799-9485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

2225 E Garvey Ave N
West Covina, CA 91791-1500

Mailing address

2225 E Garvey Ave N
West Covina, CA 91791-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220614000311 CA Part B Supplier - Clinic/Group Practice 6800275322 Receives reassigned benefits from 1 practitioner
Practice locations: Novato, CA; West Covina, CA

National Provider Directory

National Provider Directory

Locations

1300 Grant Ave
Ste 102
Novato, CA 94945
Phone (415) 898-2320

2233 E Garvey Ave N
Ste A
West Covina, CA 91791
Phone (626) 600-9486

Practitioners & affiliated clinicians

Practitioners 5

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": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1306402508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 E GARVEY AVE N",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 E GARVEY AVE N",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911500",
            "telephone_number": "626-966-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVAL PATEL OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "PERREIRA",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "707-799-9485",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.