Active NPI
Guy T Mouawad, OPTICIAN
- Optician
- Glendora, CA
National Provider Identifier
1467119115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- SL2668
- Practice address
- 345 W Foothill Blvd Ste E
Glendora, CA 91741-3339 - Phone
- (626) 335-5815
- NPI assigned
- Nov 17, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | SL2668 | CA | Primary |
Addresses
Primary practice location
345 W Foothill Blvd Ste E
Glendora, CA 91741-3339
Mailing address
345 W Foothill Blvd Ste E
Glendora, CA 91741-3339
Phone (626) 335-5815
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL2668 | CA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1467119115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 W FOOTHILL BLVD STE E",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917413339",
"telephone_number": "626-335-5815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 W FOOTHILL BLVD STE E",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917413339",
"telephone_number": "626-335-5815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUAWAD",
"first_name": "GUY",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-17",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "SL2668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.