W. Cynthia Blaylock, OD, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 14513 TPG Issued in CA

Legal business name

W. CYNTHIA BLAYLOCK, OD, INC

Practice address

1955 Monument Blvd
Suite 4-a
Concord, CA 94520-3873

Phone

(925) 326-0120

Fax

(925) 326-3120

NPI assigned

Sep 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Weishing Cynthia Blaylock, OD

Title

Owner

Phone

(317) 985-6420

Specialties & licenses 1

Addresses

Other names 1

• Monument Optometry Doing business as

Locations

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456099200000",
    "number": "1548638141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 MONUMENT BLVD",
            "address_2": "SUITE 4-A",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945203873",
            "telephone_number": "925-326-0120",
            "fax_number": "925-326-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 MONUMENT BLVD",
            "address_2": "SUITE 4-A",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945203873",
            "telephone_number": "925-326-0120",
            "fax_number": "925-326-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. CYNTHIA BLAYLOCK, OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2016-02-22",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "WEISHING",
        "authorized_official_middle_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-985-6420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 14513 TPG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monument Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Concord, CA
• Providers in Concord, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.