Commerce Center Optometry Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

COR 948 Issued in CA

Legal business name

COMMERCE CENTER OPTOMETRY INC.

Practice address

5520 Whittier Blvd
Los Angeles, CA 90022-4104

Phone

(323) 728-2708

Fax

(323) 728-0096

NPI assigned

Sep 26, 2005

Organization subpart

No

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

Authorized official

Name

Gina Shaunette, O.D.

Title

Treasurer

Phone

(323) 728-2708

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437145372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900224104",
            "telephone_number": "323-728-2708",
            "fax_number": "323-728-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900224104",
            "telephone_number": "323-728-2708",
            "fax_number": "323-728-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMERCE CENTER OPTOMETRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAUNETTE",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "323-728-2708",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "COR 948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.