Circle City Optometry, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT5503TPL Issued in CA

Legal business name

CIRCLE CITY OPTOMETRY, INC

Practice address

807 W Grand Blvd
# A
Corona, CA 92882-3272

Phone

(951) 735-1002

Fax

(951) 735-9150

NPI assigned

Jul 2, 2014

Organization subpart

No

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

Authorized official

Name

Nanci Marie Bell

Title

Corporate Secretary / Pract. Admin.

Phone

(951) 735-1002

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1588070262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 W GRAND BLVD",
            "address_2": "# A",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823272",
            "telephone_number": "951-735-1002",
            "fax_number": "951-735-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 W GRAND BLVD",
            "address_2": "# A",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823272",
            "telephone_number": "951-735-1002",
            "fax_number": "951-735-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIRCLE CITY OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "NANCI",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CORPORATE SECRETARY / PRACT. ADMIN.",
        "authorized_official_telephone_number": "951-735-1002"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT5503TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292905722",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.