Individual provider Active NPI

David B Rosenblum, O.D.

  • Optometrist
  • Cerritos, CA
National Provider Identifier
1376643395
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10235T Issued in CA
Practice address
326 Los Cerritos Mall
Cerritos, CA 90703-5425
Phone
(562) 860-4475
Fax
(562) 924-3526
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10235T CA Primary

Addresses

Primary practice location

326 Los Cerritos Mall
Cerritos, CA 90703-5425

Mailing address

11805 South St
Cerritos, CA 90703-6825
Phone (562) 860-4475

Other identifiers 1

IdentifierTypeStateIssuer
10235TOtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000056 CA Practitioner - Optometry 1456413905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1993
Medicare assignment
May accept Medicare assignment
Group practices
David B Rosenblum O D IncGroup PAC ID 1153550264, 5 clinicians

Practice addresses (Care Compare)

11805 E S St
Cerritos, CA 90703-6825

11805 S St
Cerritos, CA 90703-6825
Phone (562) 860-4475

21151 Newport Coast Dr
Newport Coast, CA 92657-1122
Phone (949) 640-4733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10235TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Eyecare Optometry Inc . Optometrist CurrentSince Mar 18, 2018 Accepting new patients
David B Rosenblum O D Inc Optometrist CurrentSince Apr 2, 2013 Accepting new patients
Nusite Optometry Optometrist Past Accepting new patients
Nusite Optometry Optometrist PastSince Jul 13, 2025 Accepting new patients

Locations

11805 South St
Cerritos, CA 90703
Phone (562) 860-4475

21161 Newport Coast Dr
Newport Beach, CA 92657
Phone (949) 640-4733

21151 Newport Coast Dr
Newport Coast, CA 92657
Phone (949) 640-4733

1201 N Rose Dr
Ste 100
Placentia, CA 92870
Phone (714) 528-2566

Interoperability endpoints

  • Direct secure messaging: david.rosenblum@uprisedirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376643395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11805 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036825",
            "telephone_number": "562-860-4475",
            "fax_number": "562-924-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 LOS CERRITOS MALL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035425",
            "telephone_number": "562-860-4475",
            "fax_number": "562-924-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLUM",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10235T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "10235T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.