Active NPI
Larry J Gottlieb Inc. a Professional Corporation
- Optometrist
- Lakewood, CA
National Provider Identifier
1396162418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6451T
- Legal business name
- LARRY J GOTTLIEB INC. A PROFESSIONAL CORPORATION
- Practice address
- 322 Lakewood Center Mall
Lakewood, CA 90712-2204 - Phone
- (562) 630-2020
- Fax
- (562) 633-7220
- NPI assigned
- Mar 26, 2014
- Last updated
- Mar 26, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Larry Jay Gottlieb, OD
- Title
- President
- Phone
- (562) 420-2055
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 13929T | CA | |
| Optometrist | 152W00000X | 6451T | CA | Primary |
Addresses
Primary practice location
322 Lakewood Center Mall
Lakewood, CA 90712-2204
Mailing address
322 Lakewood Center Mall
Lakewood, CA 90712-2409
Phone (562) 630-2020
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Lakewood, CA
- NPI 1609900653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395792000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1395792000000",
"number": "1396162418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 LAKEWOOD CENTER MALL",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907122409",
"telephone_number": "562-630-2020",
"fax_number": "562-633-7220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 LAKEWOOD CENTER MALL",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907122204",
"telephone_number": "562-630-2020",
"fax_number": "562-633-7220"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LARRY J GOTTLIEB INC. A PROFESSIONAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2014-03-26",
"last_updated": "2014-03-26",
"status": "A",
"authorized_official_last_name": "GOTTLIEB",
"authorized_official_first_name": "LARRY",
"authorized_official_middle_name": "JAY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "562-420-2055",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "13929T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "6451T",
"primary": true
}
],
"identifiers": [],
"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 Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.