Colima Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

13661 Issued in CA

Legal business name

COLIMA OPTOMETRY INC

Practice address

1758 Sierra Leone Ave
Suite a
Rowland Hghts, CA 91748-5837

Phone

(626) 839-2938

Fax

(951) 652-0050

NPI assigned

Feb 6, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Steve Penn, O.D.NPI 1942454749

Title

Owner

Phone

(951) 652-8738

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steve Penn, O.D.

  • Optometrist
  • Rowland Heights, CA
  • NPI 1942454749
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1366781650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N LINCOLN AVE",
            "address_2": "APT. 109",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917551719",
            "telephone_number": "917-723-6462",
            "fax_number": "951-652-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1758 SIERRA LEONE AVE",
            "address_2": "SUITE A",
            "city": "ROWLAND HGHTS",
            "state": "CA",
            "postal_code": "917485837",
            "telephone_number": "626-839-2938",
            "fax_number": "951-652-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLIMA OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "PENN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-652-8738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Rowland Hghts, CA
• Providers in Rowland Hghts, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.