Eye-Mate Optical

Primary specialty

OpticianTaxonomy code 156FX1800X

License

D3788 Issued in CA

Legal business name

EYE-MATE OPTICAL

Practice address

4214 Beverly Blvd
Room 207
Los Angeles, CA 90004-4479

Phone

(213) 380-3836

Fax

(213) 380-3836

NPI assigned

Feb 1, 2011

Organization subpart

No

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

Authorized official

Name

Mr. R Mendoza Fajardo, RSLD, RCLD

Title

Optician/Manager

Phone

(213) 380-3836

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1578869004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 BEVERLY BLVD",
            "address_2": "ROOM 207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044479",
            "telephone_number": "213-380-3836",
            "fax_number": "213-380-3836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 BEVERLY BLVD",
            "address_2": "ROOM 207",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044479",
            "telephone_number": "213-380-3836",
            "fax_number": "213-380-3836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE-MATE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-01",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "R",
        "authorized_official_middle_name": "MENDOZA",
        "authorized_official_title_or_position": "OPTICIAN/MANAGER",
        "authorized_official_telephone_number": "213-380-3836",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RSLD, RCLD"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "D3788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.