Active NPI
Mark Rudolph Bisson, O.D.
- Optometrist
- Long Beach, CA
National Provider Identifier
1457326217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9206
- Practice address
- 328 Redondo Ave
Long Beach, CA 90814-2651 - Phone
- (562) 439-0486
- Fax
- (562) 987-3596
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9206 | CA | Primary |
Addresses
Primary practice location
328 Redondo Ave
Long Beach, CA 90814-2651
Mailing address
328 Redondo Ave
Long Beach, CA 90814-2651
Phone (562) 439-0486
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457326217 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1457326217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "328 REDONDO AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908142651",
"telephone_number": "562-439-0486",
"fax_number": "562-987-3596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "328 REDONDO AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908142651",
"telephone_number": "562-439-0486",
"fax_number": "562-987-3596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISSON",
"first_name": "MARK",
"middle_name": "RUDOLPH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9206",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457326217",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.