Active NPI
Timothy B Edrington, OD
- Optometrist
- Fullerton, CA
National Provider Identifier
1386652394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6644TPA
- Practice address
- 2575 Yorba Linda Blvd
Fullerton, CA 92831-1699 - Phone
- (714) 449-7422
- Fax
- (714) 992-7871
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6644TPA | CA | Primary |
Addresses
Primary practice location
2575 Yorba Linda Blvd
Fullerton, CA 92831-1699
Mailing address
2575 Yorba Linda Blvd
Fullerton, CA 92831-1699
Phone (714) 449-7422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6644TPA | CA | MD | Optometrist |
| 6644 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386652394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2575 YORBA LINDA BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928311699",
"telephone_number": "714-449-7422",
"fax_number": "714-992-7871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2575 YORBA LINDA BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928311699",
"telephone_number": "714-449-7422",
"fax_number": "714-992-7871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDRINGTON",
"first_name": "TIMOTHY",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "6644TPA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.