NPIMap

Organization Active NPI

Marvin C Mah, OD, Inc

  • Optometrist
  • Fremont, CA
National Provider Identifier
1437417433
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CA6996T Issued in CA
Legal business name
MARVIN C MAH, OD, INC
Practice address
1556 Washington Blvd
Fremont, CA 94539-5100
Phone
(510) 438-0508
Fax
(510) 661-2362
NPI assigned
Apr 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Dr. Marvin C Mah, O.D.NPI 1245228402
Title
President
Phone
(510) 438-0508

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X CA6996T CA Primary

Addresses

Primary practice location

1556 Washington Blvd
Fremont, CA 94539-5100

Mailing address

1556 Washington Blvd
Fremont, CA 94539-5100
Phone (510) 438-0508

National Provider Directory

National Provider Directory

Locations

1556 Washington Blvd
Fremont, CA 94539
Phone (510) 438-0508

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": "1335398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1437417433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1556 WASHINGTON BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395100",
            "telephone_number": "510-438-0508",
            "fax_number": "510-661-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1556 WASHINGTON BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395100",
            "telephone_number": "510-438-0508",
            "fax_number": "510-661-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN C MAH, OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "MAH",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-438-0508",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "CA6996T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.