Individual provider Active NPI

Mitra Foroodi

  • Optometrist
  • San Fernando, CA
National Provider Identifier
1407301732
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33562-TLG Issued in CA
Practice address
906 San Fernando Rd
San Fernando, CA 91340-3311
Phone
(818) 294-9392
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT33562-TLG CA Primary

Addresses

Primary practice location

906 San Fernando Rd
San Fernando, CA 91340-3311

Mailing address

906 San Fernando Rd
San Fernando, CA 91340-3311
Phone (818) 294-9392

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

LicenseStateTypeSpecialty
OPT33562-TLGCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1407301732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 SAN FERNANDO RD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403311",
            "telephone_number": "818-294-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 SAN FERNANDO RD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403311",
            "telephone_number": "818-294-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOROODI",
        "first_name": "MITRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33562-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fernando, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.