Individual provider Active NPI

Mally Azarmipur, O.D.

  • Optometrist
  • Oxnard, CA
National Provider Identifier
1467516369
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT12512 Issued in CA
Practice address
650 Meta St
Oxnard, CA 93030-7182
Phone
(805) 487-5351
Fax
(805) 487-2599
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT12512 CA Primary

Addresses

Primary practice location

650 Meta St
Oxnard, CA 93030-7182

Mailing address

1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930

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
I20040929001288 CA Practitioner - Optometry 5092784652 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT12512CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc Current Accepting new patients
Clinicas del Camino Real, Inc CurrentSince Oct 14, 2019 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Oct 14, 2019 Accepting new patients
Luxottica of America Inc Past Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Clinicas del Camino Real Inc PastSince Oct 6, 2019 Accepting new patients
Clinicas del Camino Real Inc PastSince Oct 6, 2019 Accepting new patients

Locations

650 Meta St
Oxnard, CA 93030
Phone (805) 487-5351

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

Interoperability endpoints

  • Direct secure messaging: mazarmipur802580@direct.ochin.org
  • Direct secure messaging: mally.azarmipur.p1@direct.clinicas.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1467516369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 META ST",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930307182",
            "telephone_number": "805-487-5351",
            "fax_number": "805-487-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZARMIPUR",
        "first_name": "MALLY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.