Optometric Centers

Primary specialty

OptometristTaxonomy code 152W00000X

License

12701T Issued in CA

Legal business name

OPTOMETRIC CENTERS

Practice address

12968 Frederick St Ste a
Moreno Valley, CA 92553-5229

Phone

(951) 924-1877

Fax

(951) 485-3580

NPI assigned

May 21, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ethan M Clayton, O.D.NPI 1629130257

Title

Optomotrist

Phone

(951) 924-1877

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ethan M Clayton, O.D.

  • Optometrist
  • Moreno Valley, CA
  • NPI 1629130257
  Authorized official Same address or phone

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528277175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12968 FREDERICK ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535229",
            "telephone_number": "951-924-1877",
            "fax_number": "951-485-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12968 FREDERICK ST STE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535229",
            "telephone_number": "951-924-1877",
            "fax_number": "951-485-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPTOMOTRIST",
        "authorized_official_telephone_number": "951-924-1877",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12701T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0093410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• One Acupuncture Clinic Inc
• Amanda Onn
• Ontario Prosthetics
• Ogonna Onyemata
• Operation Safe House, Inc.
• Opulence Hospice Care,Inc
• Miles Arnold Orantia, DO
• Eugene Michael Oriola, D.D.S.
• Uchenna G Orji, FNP-C
• Jhon Alexander Orozco Arismendy, DO

• Optometrist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.