Manhattan Beach Vision Group - Optometry, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

006029T Issued in CA

Legal business name

MANHATTAN BEACH VISION GROUP - OPTOMETRY, INC

Practice address

946 Manhattan Beach Blvd
Manhattan Beach, CA 90266-5120

Phone

(310) 545-4585

Fax

(310) 546-3240

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Funnell, O.D.

Title

Optometrist

Phone

(310) 545-4585

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1336333749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 MANHATTAN BEACH BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665120",
            "telephone_number": "310-545-4585",
            "fax_number": "310-546-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 MANHATTAN BEACH BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665120",
            "telephone_number": "310-545-4585",
            "fax_number": "310-546-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANHATTAN BEACH VISION GROUP - OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "FUNNELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "310-545-4585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "006029T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.