Active NPI
Efrem Jonathan Prado, O.D.
- Optometrist
- San Diego, CA
National Provider Identifier
1578876447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 942991598
- Practice address
- 3625 Midway Dr
Ste P
San Diego, CA 92110-5253 - Phone
- (619) 223-3028
- Fax
- (619) 223-3042
- NPI assigned
- Jul 21, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 942991598 | CA | Primary |
Addresses
Primary practice location
3625 Midway Dr
Ste P
San Diego, CA 92110-5253
Mailing address
3625 Midway Dr
Ste P
San Diego, CA 92110-5253
Phone (510) 461-3931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Eyewear Supplier
- Riverside, CA
- NPI 1366598120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1578876447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3625 MIDWAY DR",
"address_2": "STE P",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921105253",
"telephone_number": "510-461-3931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 MIDWAY DR",
"address_2": "STE P",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921105253",
"telephone_number": "619-223-3028",
"fax_number": "619-223-3042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRADO",
"first_name": "EFREM",
"middle_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-21",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "942991598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.