NPIMap

Organization Active NPI

Imperial Valley Optometric Corporation

  • Optometrist
  • El Centro, CA
National Provider Identifier
1497032783
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CA11960T Issued in CA
Legal business name
IMPERIAL VALLEY OPTOMETRIC CORPORATION
Practice address
700 Imperial Ave
El Centro, CA 92243-9140
Phone
(760) 336-3003
Fax
(888) 210-5799
NPI assigned
Nov 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Dr. May C Tam, O.D.
Title
Vice President
Phone
(760) 336-3003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X CA11960T CA Primary

Addresses

Primary practice location

700 Imperial Ave
El Centro, CA 92243-9140

Mailing address

3451 S Dogwood Ave
Ste 1334
El Centro, CA 92243-9140
Phone (760) 336-3003

Other identifiers 1

IdentifierTypeStateIssuer
GSD005600MedicaidCA

Other names 1

  • Optom-eyes Vision Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Imperial Valley Optometric Corporation14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

700 N Imperial Ave
El Centro, CA 92243
Phone (760) 336-0010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1497032783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 S DOGWOOD AVE",
            "address_2": "STE 1334",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439140",
            "telephone_number": "760-336-3003",
            "fax_number": "888-210-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439140",
            "telephone_number": "760-336-3003",
            "fax_number": "888-210-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL VALLEY OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "TAM",
        "authorized_official_first_name": "MAY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "760-336-3003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "CA11960T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD005600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optom-eyes Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.