NPIMap

Organization Active NPI

Chico Optical Dispensers

  • Eyewear Supplier
  • Chico, CA
National Provider Identifier
1417135328
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
CHICO OPTICAL DISPENSERS
Practice address
1722 Mangrove Ave Ste 32
Chico, CA 95926-2300
Phone
(530) 895-1474
Fax
(530) 895-1441
NPI assigned
Feb 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Authorized official

Name
Randel Edward JohansonNPI 1902988074
Title
Owner
Phone
(530) 895-1474

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
Eyewear Supplier 332H00000X CA Primary

Addresses

Primary practice location

1722 Mangrove Ave Ste 32
Chico, CA 95926-2300

Mailing address

1722 Mangrove Ave Ste 32
Chico, CA 95926-2300
Phone (530) 895-1474

National Provider Directory

National Provider Directory

Locations

1722 Mangrove Ave
Ste 32
Chico, CA 95926
Phone (530) 895-1474

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": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1417135328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 MANGROVE AVE STE 32",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262300",
            "telephone_number": "530-895-1474",
            "fax_number": "530-895-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 MANGROVE AVE STE 32",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262300",
            "telephone_number": "530-895-1474",
            "fax_number": "530-895-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICO OPTICAL DISPENSERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "JOHANSON",
        "authorized_official_first_name": "RANDEL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-895-1474"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.