Organization Active NPI

California Avenue Optometry & Contact Lens Clinic

  • Optometrist
  • Palo Alto, CA
National Provider Identifier
1629110861
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
FNP 2950 Issued in CA
Legal business name
CALIFORNIA AVENUE OPTOMETRY & CONTACT LENS CLINIC
Practice address
456 S California Ave
Palo Alto, CA 94306-1605
Phone
(650) 617-2020
Fax
(650) 617-4550
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dan Alan Baggett, O.D.
Title
Optometrist Owner Partner
Phone
(650) 617-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X FNP 2950 CA Primary

Addresses

Primary practice location

456 S California Ave
Palo Alto, CA 94306-1605

Mailing address

456 S California Ave
Palo Alto, CA 94306-1605
Phone (650) 617-2020

National Provider Directory

National Provider Directory

Locations

456 California Ave
Palo Alto, CA 94306
Phone (650) 617-2020

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629110861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 S CALIFORNIA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061605",
            "telephone_number": "650-617-2020",
            "fax_number": "650-617-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 S CALIFORNIA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061605",
            "telephone_number": "650-617-2020",
            "fax_number": "650-617-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA AVENUE OPTOMETRY & CONTACT LENS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAGGETT",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER PARTNER",
        "authorized_official_telephone_number": "650-617-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "FNP 2950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.