Taylor Woodbury Bladh, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT8921TPG Issued in CA

Practice address

718 N. Diamond Bar Blvd.
Diamond Bar, CA 91765-4122

Phone

(909) 861-3737

Fax

(909) 396-7517

NPI assigned

Nov 21, 2006

Last updated

Apr 10, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Southern California College of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• Total Vision PC

  dba Total Vision

  • Optometrist
  • San Diego, CA
  • NPI 1356813711
  Medicare reassignment Care Compare group NPD
• Department of State Hospitals

  dba Coalinga State Hospital

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Dr. Taylor Bladh O.D. Inc

  dba Newport Harbor Optometry

  • Optometrist
  • Costa Mesa, CA
  • NPI 1700440633
  Authorized official Same address or phone
• Dr. Taylor Bladh, O.D., Inc

  • Optometrist
  • Diamond Bar, CA
  • NPI 1700951217
  Authorized official Same address or phone
• Department of State Hospitals

  dba Department of State Hospitals - Patton

  • Psychiatric Hospital
  • Patton, CA
  • NPI 1043249204
  NPD
• Department of State Hospitals

  dba Department of State Hospitals-Atascadero

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD
• Gregory Y. Kame, O.D., F.a.a.O., a Professional Corporation

  dba Los Angeles EyeCare Optometry Group

  • Corneal and Contact Management Optometrist
  • Los Angeles, CA
  • NPI 1053343137
  NPD
• Crum Optometric Group, Inc

  • Optometrist
  • Chino Hills, CA
  • NPI 1831378843
  NPD (past)
• Dr. Kenneth Boyer, O.D., Inc

  • Optometrist
  • La Verne, CA
  • NPI 1316012834
  NPD (past)
• Dr.Harvey Goldstone, a Professional Corporation

  • Optometrist
  • Long Beach, CA
  • NPI 1316156037
  NPD (past)
• Marina Eyecare Center

  dba Pacific EyeCare Center

  • Optometrist
  • Los Angeles, CA
  • NPI 1407917701
  NPD (past)
• Mark a. Chung, O.D., a Professional Corporation

  dba West Hollywood Optometric Center

  • Optometrist
  • West Hollywood, CA
  • NPI 1861800997
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1467527028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N. DIAMOND BAR BLVD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654122",
            "telephone_number": "909-861-3737",
            "fax_number": "909-396-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 N. DIAMOND BAR BLVD.",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654122",
            "telephone_number": "909-861-3737",
            "fax_number": "909-396-7517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1796 Newport Blvd",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926272756",
            "country_code": "US",
            "telephone_number": "949-642-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLADH",
        "first_name": "TAYLOR",
        "middle_name": "WOODBURY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8921TPA",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8921TPG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0088870",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0081970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.