NPIMap

Organization Active NPI

Charles a Jansen, OD, Inc

  • Optometrist
  • Riverside, CA
National Provider Identifier
1336342237
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8158T Issued in CA
Legal business name
CHARLES A JANSEN, OD, INC
Practice address
4000 Tyler St.
Riverside, CA 92503
Phone
(951) 687-7100
Fax
(951) 687-1663
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Authorized official

Name
Dr. Charles A Jansen, O.D.
Title
Dr Owner
Phone
(951) 678-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 8158T CA Primary

Addresses

Primary practice location

4000 Tyler St.
Riverside, CA 92503

Mailing address

4000 Tyler St.
Riverside, CA 92503
Phone (951) 687-7100

National Provider Directory

National Provider Directory

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": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1336342237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 TYLER ST.",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92503",
            "telephone_number": "951-687-7100",
            "fax_number": "951-687-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 TYLER ST.",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92503",
            "telephone_number": "951-687-7100",
            "fax_number": "951-687-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES A JANSEN, OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "JANSEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DR OWNER",
        "authorized_official_telephone_number": "951-678-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8158T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.