Robert A Wayda, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5807 TPA Issued in CA

Practice address

204 N K St
Dinuba, CA 93618-1926

Phone

(559) 591-1025

Fax

(559) 591-9345

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1558360701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N K ST",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936181926",
            "telephone_number": "559-591-1025",
            "fax_number": "559-591-9345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N K ST",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936181926",
            "telephone_number": "559-591-1025",
            "fax_number": "559-591-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYDA",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5807 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0058070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.