Individual provider Active NPI

Arian Fartash, O.D.

  • Optometrist
  • Corona, CA
National Provider Identifier
1417263500
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT14066TLG Issued in CA
Practice address
734 N Main St
Corona, CA 92880-1439
Phone
(951) 737-2020
NPI assigned
Aug 26, 2010
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT14066TLG CA Primary

Addresses

Primary practice location

734 N Main St
Corona, CA 92880-1439

Mailing address

734 N Main St
Corona, CA 92878-5839
Phone (951) 737-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000308 CA Practitioner - Optometry 7012199383 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT14066TLGCAMDOptometrist
14066CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Eyecare Optometry Inc Optometrist CurrentSince Mar 26, 2012 Accepting new patients
Dpmotikonrca LLC PastSince Mar 30, 2016 Accepting new patients

Locations

425 W Bonita Ave
Ste 110B
San Dimas, CA 91773
Phone (909) 394-0462

1335 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (562) 867-0811

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1417263500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 N MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928785839",
            "telephone_number": "951-737-2020",
            "fax_number": "951-737-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 N MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928801439",
            "telephone_number": "951-737-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARTASH",
        "first_name": "ARIAN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT14066TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.