Organization Active NPI

Dr Daniel M Beltran OD Inc

  • Optometrist
  • La Puente, CA
National Provider Identifier
1396935680
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8175T Issued in CA
Legal business name
DR DANIEL M BELTRAN OD INC
Practice address
13959 Amar Rd
La Puente, CA 91746-1679
Phone
(626) 960-2736
Fax
(626) 962-3227
NPI assigned
Aug 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Authorized official

Name
Dr. Daniel M Beltran, ODNPI 1073543211
Title
President
Phone
(626) 960-2736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 8175T CA Primary

Addresses

Primary practice location

13959 Amar Rd
La Puente, CA 91746-1679

Mailing address

13959 Amar Rd
La Puente, CA 91746-1679
Phone (626) 960-2736

Other identifiers 1

IdentifierTypeStateIssuer
SD0081750MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080207000566 CA Part B Supplier - Clinic/Group Practice 0244247112 Receives reassigned benefits from 1 practitioner
Practice locations: La Puente, CA

National Provider Directory

National Provider Directory

Locations

13959 Amar Rd
La Puente, CA 91746
Phone (626) 960-2736

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1396935680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13959 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461679",
            "telephone_number": "626-960-2736",
            "fax_number": "626-962-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13959 AMAR RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461679",
            "telephone_number": "626-960-2736",
            "fax_number": "626-962-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DANIEL M BELTRAN OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "BELTRAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-960-2736",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8175T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0081750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.