NPIMap

Organization Active NPI

Marina Eyecare Center

Doing business as Pacific EyeCare Center

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1407917701
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7001T Issued in CA
Legal business name
MARINA EYECARE CENTER
Doing business as
Pacific EyeCare Center
Practice address
12461 W Washington Blvd
Los Angeles, CA 90066-5511
Phone
(310) 390-6287
Fax
(310) 391-8464
NPI assigned
Dec 12, 2006
Last updated
Mar 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Authorized official

Name
Dr. Donald M Matsumoto, O.D.
Title
Owner
Phone
(310) 390-6287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7001T CA Primary

Addresses

Primary practice location

12461 W Washington Blvd
Los Angeles, CA 90066-5511

Mailing address

12461 W Washington Blvd
Los Angeles, CA 90066-5511
Phone (310) 390-6287

Other names 1

  • Pacific EyeCare Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 79

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.

View all 79

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519862400000",
    "number": "1407917701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12461 W WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665511",
            "telephone_number": "310-390-6287",
            "fax_number": "310-391-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12461 W WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665511",
            "telephone_number": "310-390-6287",
            "fax_number": "310-391-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA EYECARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-03-01",
        "status": "A",
        "authorized_official_last_name": "MATSUMOTO",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-390-6287",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7001T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific EyeCare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.