NPIMap

Organization Active NPI

John L Nelson

  • Optometrist
  • Castro Valley, CA
National Provider Identifier
1487789327
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4985 Issued in CA
Legal business name
JOHN L NELSON
Practice address
20211 Patio Dr
Suite 100
Castro Valley, CA 94546-4338
Phone
(510) 881-4401
Fax
(510) 881-4423
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Dr. John L Nelson, O.D.
Title
Owner
Phone
(510) 881-4401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4985 CA Primary

Addresses

Primary practice location

20211 Patio Dr
Suite 100
Castro Valley, CA 94546-4338

Mailing address

20211 Patio Dr
Suite 100
Castro Valley, CA 94546-4338
Phone (510) 881-4401

Other names 1

  • Vision Gallery Optometric Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John L Nelson2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

20211 Patio Dr
Ste 100
Castro Valley, CA 94546
Phone (510) 881-4401

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1487789327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20211 PATIO DR",
            "address_2": "SUITE 100",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464338",
            "telephone_number": "510-881-4401",
            "fax_number": "510-881-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20211 PATIO DR",
            "address_2": "SUITE 100",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464338",
            "telephone_number": "510-881-4401",
            "fax_number": "510-881-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN L NELSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-881-4401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "4985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Gallery Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.