Dr. Kenneth Boyer, O.D., Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR. KENNETH BOYER, O.D., INC

Practice address

2443 Foothill Blvd
La Verne, CA 91750-3028

Phone

(909) 596-6756

Fax

(909) 593-0786

NPI assigned

Nov 21, 2006

Last updated

Mar 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth James Boyer, O.D.NPI 1801961453

Title

President / Optometrist

Phone

(909) 596-6756

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 4

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.

• Kenneth James Boyer, O.D.

  • Optometrist
  • La Verne, CA
  • NPI 1801961453
  Medicare reassignment NPD Authorized official
• Brian Craig Boyer, O.D.

  • Optometrist
  • La Verne, CA
  • NPI 1215341896
  Medicare reassignment
• Taylor Woodbury Bladh, O.D.

  • Optometrist
  • Diamond Bar, CA
  • NPI 1467527028
  NPD (past)
• Effie Sen, O.D.

  • Optometrist
  • Diamond Bar, CA
  • NPI 1417017385
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1316012834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503028",
            "telephone_number": "909-596-6756",
            "fax_number": "909-593-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503028",
            "telephone_number": "909-596-6756",
            "fax_number": "909-593-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KENNETH BOYER, O.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "BOYER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT / OPTOMETRIST",
        "authorized_official_telephone_number": "909-596-6756",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD000651",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Boval DDS a Professional Dental Corp (Gold Coast Dental)
• Mini Diblasi, M.S.
• Kim Dinh, PA-C
• Donald J Guido OD Inc (La Verne Optometry)
• Jason Dorn, MPT
• Dr. Kim Optometry Inc
• Makayla Draeger
• George Manuel Dualan, M.D.
• Omar Angelo Dula
• Joseph Duran

• Optometrist in La Verne, CA
• Providers in La Verne, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.