Elise Brisco, OD FAAO

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT8894 Issued in CA

Practice address

955 Carrillo Dr
Ste 105
Los Angeles, CA 90048

Phone

(323) 954-5800

Fax

(323) 954-5807

NPI assigned

Apr 10, 2006

Last updated

Jun 27, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hollywood Vision Center Optometry, Inc.

  • Optometrist
  • Los Angeles, CA
  • NPI 1164728036
  Authorized official Same address or phone
• Mark a. Chung, O.D., a Professional Corporation

  dba West Hollywood Optometric Center

  • Optometrist
  • West Hollywood, CA
  • NPI 1861800997
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1457314452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 CARRILLO DR",
            "address_2": "STE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "323-954-5800",
            "fax_number": "323-954-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CARRILLO DR",
            "address_2": "STE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "323-954-5800",
            "fax_number": "323-954-5807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISCO",
        "first_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "OD FAAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S0008994",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Briones, BSN, RN, PHN
• Robert Ricardo Briones, PSY. D.
• Vasni Y Briones
• Glenda Brisbane, M.S.
• Wayne Grover Brisbane, M.D.
• Kimberly Andrea Brisco
• Tara Michelle Brisco, LCSW
• Krishann Melody Briscoe
• Sierra K. Briscoe, LMFT
• Kelvin Briscoll

• 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 Jun 27, 2011; 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.