Individual provider Active NPI

Page Allen Yarwood, O.D.

  • Optometrist
  • Oakland, CA
National Provider Identifier
1447303151
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
06144T Issued in CA
Practice address
3772 Howe St
Oakland, CA 94611-5311
Phone
(510) 752-6633
Fax
(510) 752-7742
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 06144T CA Primary

Addresses

Primary practice location

3772 Howe St
Oakland, CA 94611-5311

Mailing address

609 Kenwyn Rd
Oakland, CA 94610-3714
Phone (510) 763-7736

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
I20140416001384 CA Practitioner - Optometry 2062644586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06144TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare Professional Optometric Group Optometrist CurrentSince Apr 1, 2014 Accepting new patients

Locations

330 N Brand Blvd
Ste 110
Glendale, CA 91203
Phone (818) 240-0890

1055 Foothill Blvd
La Canada, CA 91011

6702 Inglewood Ave
Ste H
Stockton, CA 95207
Phone (209) 951-3937

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447303151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 KENWYN RD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103714",
            "telephone_number": "510-763-7736",
            "fax_number": "510-752-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 HOWE ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115311",
            "telephone_number": "510-752-6633",
            "fax_number": "510-752-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARWOOD",
        "first_name": "PAGE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "06144T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.