Organization Active NPI

Jeffrey a Holbert O D a Professional Corporation

Doing business as Dr. Holbert, Optometrist

  • Optometrist
  • Sunnyvale, CA
National Provider Identifier
1588710305
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
05876T Issued in CA
Legal business name
JEFFREY A HOLBERT O D A PROFESSIONAL CORPORATION
Doing business as
Dr. Holbert, Optometrist
Practice address
320 W El Camino Real
Suite B-1
Sunnyvale, CA 94087-1306
Phone
(408) 245-5725
Fax
(408) 356-1271
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Authorized official

Name
Dr. Jeffrey Alan Holbert, O.D.
Title
President
Phone
(408) 245-5725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 05876T CA Primary

Addresses

Primary practice location

320 W El Camino Real
Suite B-1
Sunnyvale, CA 94087-1306

Mailing address

320 W El Camino Real
Suite B-1
Sunnyvale, CA 94087-1306
Phone (408) 245-5725

Other names 1

  • DR. HOLBERT, OPTOMETRIST Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130806000254 CA Part B Supplier - Clinic/Group Practice 2567604481 Receives reassigned benefits from 4 practitioners
Practice locations: Santa Clara, CA

National Provider Directory

National Provider Directory

Locations

925 Blossom Hill Rd
Ste 1139
San Jose, CA 95123
Phone (408) 281-3381

2855 Stevens Creek Blvd
Ste 1151
Santa Clara, CA 95050
Phone (408) 243-9394

320 W El Camino Real
Ste B1
Sunnyvale, CA 94087
Phone (408) 245-5725

320 W El Camino Real
#B1
Sunnyvale, CA 94087

Practitioners & affiliated clinicians

Practitioners 5

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1588710305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W EL CAMINO REAL",
            "address_2": "SUITE B-1",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940871306",
            "telephone_number": "408-245-5725",
            "fax_number": "408-356-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W EL CAMINO REAL",
            "address_2": "SUITE B-1",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940871306",
            "telephone_number": "408-245-5725",
            "fax_number": "408-356-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY A HOLBERT O D A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "HOLBERT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-245-5725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "05876T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR. HOLBERT, OPTOMETRIST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.