Larry Jay Gottlieb, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

6451T Issued in CA

Practice address

6418 Del Amo Blvd
Lakewood, CA 90713-2204

Phone

(562) 420-2055

Fax

(562) 420-1784

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Larry J Gottlieb Inc a Professional Corporation

  • Optometrist
  • Lakewood, CA
  • NPI 1013176130
  Medicare reassignment NPD Authorized official
• Larry J Gottlieb Inc a Professional Corporation

  • Optometrist
  • Lakewood, CA
  • NPI 1235537119
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609900653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 DEL AMO BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907132204",
            "telephone_number": "562-420-2055",
            "fax_number": "562-420-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 DEL AMO BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907132204",
            "telephone_number": "562-420-2055",
            "fax_number": "562-420-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "LARRY",
        "middle_name": "JAY",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6451T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bria Gordon
• Marvin Isaac Gordon, M.D
• Scott A Gordon, MD
• Gottlieb Optometry Corporation
• Donald Samuel Gottlieb, O.D.
• Robert Gottlieb, M.D.
• Amy Gould
• Shobha B Govind, MD
• David Charles Graham, D.P.M.
• Janae Graham

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.