Individual provider Active NPI

Sol Regwan, O.D.

  • Optometrist
  • Encino, CA
National Provider Identifier
1457471393
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11595T Issued in CA
Practice address
16430 Ventura Blvd Ste 106
Encino, CA 91436-2135
Phone
(818) 905-3233
NPI assigned
Mar 31, 2007
Last updated
Nov 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11595T CA Primary

Addresses

Primary practice location

16430 Ventura Blvd Ste 106
Encino, CA 91436-2135

Mailing address

18963 Ventura Blvd
Tarzana, CA 91356-3229
Phone (818) 996-3233

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
I20040406001246 CA Practitioner - Optometry 3476546359 Practice locations: Tarzana, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11595TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1457471393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18963 VENTURA BLVD",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563229",
            "telephone_number": "818-996-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16430 VENTURA BLVD STE 106",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362135",
            "telephone_number": "818-905-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGWAN",
        "first_name": "SOL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-31",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11595T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.