NPIMap

Organization Active NPI

Verdugo Optical

  • Optician
  • Glendale, CA
National Provider Identifier
1588103790
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
D70721 Issued in CA
Legal business name
VERDUGO OPTICAL
Practice address
1808 Verdugo Blvd
#120
Glendale, CA 91208-1477
Phone
(818) 952-1124
Fax
(818) 952-3809
NPI assigned
Feb 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Authorized official

Name
Rita DerkalousdianNPI 1669280582
Title
Owner
Phone
(818) 952-1124

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X D70721 CA Primary

Addresses

Primary practice location

1808 Verdugo Blvd
#120
Glendale, CA 91208-1477

Mailing address

1808 Verdugo Blvd
#120
Glendale, CA 91208-1477
Phone (818) 952-1124

National Provider Directory

National Provider Directory

Locations

1808 Verdugo Blvd
Ste 120
Glendale, CA 91208
Phone (818) 469-9966

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1588103790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD",
            "address_2": "#120",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081477",
            "telephone_number": "818-952-1124",
            "fax_number": "818-952-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD",
            "address_2": "#120",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081477",
            "telephone_number": "818-952-1124",
            "fax_number": "818-952-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERDUGO OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "DERKALOUSDIAN",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-952-1124"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "D70721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.