Organization Active NPI

Craig B. Scheffel, O.D., Inc.

  • Optometrist
  • Lakewood, CA
National Provider Identifier
1366566317
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5938T Issued in CA
Legal business name
CRAIG B. SCHEFFEL, O.D., INC.
Practice address
17 Lakewood Center Mall
Lakewood, CA 90712-2417
Phone
(562) 633-6443
Fax
(562) 633-6939
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Craig Bruce Scheffel, O.D.
Title
President, Owner
Phone
(562) 633-6443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5938T CA Primary

Addresses

Primary practice location

17 Lakewood Center Mall
Lakewood, CA 90712-2417

Mailing address

17 Lakewood Center Mall
Lakewood, CA 90712-2417
Phone (562) 633-6443

Other identifiers 1

IdentifierTypeStateIssuer
GSD004180MedicaidCA

National Provider Directory

National Provider Directory

Locations

17 Lakewood Center Mall
Lakewood, CA 90712
Phone (562) 633-6443

Practitioners & affiliated clinicians

Practitioners 2

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366566317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LAKEWOOD CENTER MALL",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122417",
            "telephone_number": "562-633-6443",
            "fax_number": "562-633-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LAKEWOOD CENTER MALL",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122417",
            "telephone_number": "562-633-6443",
            "fax_number": "562-633-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG B. SCHEFFEL, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHEFFEL",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "562-633-6443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5938T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.