NPIMap

Organization Active NPI

Modo Optometry

  • Optometrist
  • Marina del Rey, CA
National Provider Identifier
1366764862
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10307T Issued in CA
Legal business name
MODO OPTOMETRY
Practice address
4718 Admiralty Way # B
Marina del Rey, CA 90292-6905
Phone
(310) 305-2950
Fax
(310) 458-4799
NPI assigned
Feb 24, 2010
Organization subpart
Yes
Parent organization
DR. S. DAYYANI, O.D., A PROFESSIONAL OPTOMETRIC CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Authorized official

Name
Dr. Shahrokh Dayyani, O.D.NPI 1194893008
Title
President
Phone
(310) 305-2950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 10307T CA Primary

Addresses

Primary practice location

4718 Admiralty Way # B
Marina del Rey, CA 90292-6905

Mailing address

4718 Admiralty Way # B
Marina del Rey, CA 90292-6905
Phone (310) 305-2950

National Provider Directory

National Provider Directory
Tax ID family
Dr S Dayyani OD a Prof Corp2 organizations share this tax ID, including this one
Part of
Dr S Dayyani OD a Prof Corp

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4718 Admiralty Way
#B
Marina del Rey, CA 90292
Phone (310) 305-2950

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": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1366764862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4718 ADMIRALTY WAY # B",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-305-2950",
            "fax_number": "310-458-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4718 ADMIRALTY WAY # B",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-305-2950",
            "fax_number": "310-458-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODO OPTOMETRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR. S. DAYYANI, O.D., A PROFESSIONAL OPTOMETRIC CORP.",
        "enumeration_date": "2010-02-24",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "DAYYANI",
        "authorized_official_first_name": "SHAHROKH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-305-2950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10307T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.