Organization Active NPI

Jeffrey H Brown Optometry P C

  • Clinic/Center
  • Costa Mesa, CA
National Provider Identifier
1457646226
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
8065T Issued in CA
Legal business name
JEFFREY H BROWN OPTOMETRY P C
Practice address
1175 Baker St
E-16
Costa Mesa, CA 92626-4101
Phone
(714) 979-1811
Fax
(714) 979-2025
NPI assigned
Jun 9, 2011
Last updated
Jun 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Authorized official

Name
Dr. Jeffrey H Brown, O.DNPI 1891853917
Title
Owner
Phone
(714) 979-1811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 8065T CA Primary

Addresses

Primary practice location

1175 Baker St
E-16
Costa Mesa, CA 92626-4101

Mailing address

1175 Baker St
E-16
Costa Mesa, CA 92626-4101
Phone (714) 979-1811

Other identifiers 1

IdentifierTypeStateIssuer
SD0080650MedicaidCA

National Provider Directory

National Provider Directory

Locations

1175 Baker St
Ste E16
Costa Mesa, CA 92626
Phone (714) 979-1811

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1457646226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 BAKER ST",
            "address_2": "E-16",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264101",
            "telephone_number": "714-979-1811",
            "fax_number": "714-979-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 BAKER ST",
            "address_2": "E-16",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264101",
            "telephone_number": "714-979-1811",
            "fax_number": "714-979-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY H BROWN OPTOMETRY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-979-1811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "8065T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0080650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.