Active NPI
Richard Paul Bozner, O.D.
- Optometrist
- Riverside, CA
National Provider Identifier
1407929961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7140T
- Practice address
- 4212 Market St.
Riverside, CA 92501 - Phone
- (951) 684-9700
- Fax
- (951) 684-4515
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 7140T | CA | Primary |
Addresses
Primary practice location
4212 Market St.
Riverside, CA 92501
Mailing address
4212 Market St.
Riverside, CA 92501
Phone (951) 684-9700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0071400 | Medicaid | CA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7140T | CA | MD | Optometrist |
| 7140 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305590400000",
"number": "1407929961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4212 MARKET ST.",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92501",
"telephone_number": "951-684-9700",
"fax_number": "951-684-4515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4212 MARKET ST.",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92501",
"telephone_number": "951-684-9700",
"fax_number": "951-684-4515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOZNER",
"first_name": "RICHARD",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2011-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "7140T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0071400",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.