Individual provider Active NPI

Martin Dennis Guevara, O.D.

  • Optometrist
  • Torrance, CA
National Provider Identifier
1326194606
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7958T Issued in CA
Practice address
3524 Torrance Blvd
Ste 100
Torrance, CA 90503-4821
Phone
(310) 316-2055
Fax
(310) 316-2058
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7958T CA Primary

Addresses

Primary practice location

3524 Torrance Blvd
Ste 100
Torrance, CA 90503-4821

Mailing address

3524 Torrance Blvd
Ste 100
Torrance, CA 90503-4821
Phone (310) 316-2055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526001001 CA Practitioner - Optometry 9830228048 Practice locations: Torrance, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3524 Torrance Blvd
Suite 100
Torrance, CA 90503-4821
Phone (310) 316-2055

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7958TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1326194606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 TORRANCE BLVD",
            "address_2": "STE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034821",
            "telephone_number": "310-316-2055",
            "fax_number": "310-316-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 TORRANCE BLVD",
            "address_2": "STE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034821",
            "telephone_number": "310-316-2055",
            "fax_number": "310-316-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "MARTIN",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7958T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.