Active NPI
Natalie Iriana Tailo, OD
- Optometrist
- Menlo Park, CA
National Provider Identifier
1396302162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 34088TLG
- Practice address
- 700 El Camino Real Ste 160
Menlo Park, CA 94025-4882 - Phone
- (650) 329-8181
- NPI assigned
- May 28, 2019
- Last updated
- May 28, 2019
- Sex
- Female
- 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 | 34088TLG | CA | Primary |
Addresses
Primary practice location
700 El Camino Real Ste 160
Menlo Park, CA 94025-4882
Mailing address
1301 Hobart St
Menlo Park, CA 94025-5518
Phone (661) 993-5805
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34088TLG | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559001600000",
"number": "1396302162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 HOBART ST",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940255518",
"telephone_number": "661-993-5805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 EL CAMINO REAL STE 160",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254882",
"telephone_number": "650-329-8181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAILO",
"first_name": "NATALIE",
"middle_name": "IRIANA",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-28",
"last_updated": "2019-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "34088TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.