Individual provider Active NPI

John E. Larcabal, O.D.

  • Optometrist
  • Norwalk, CA
National Provider Identifier
1639172273
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9029T Issued in CA
Practice address
12138 Firestone Blvd
Norwalk, CA 90650-4320
Phone
(562) 868-8233
Fax
(562) 868-8283
NPI assigned
May 27, 2005
Last updated
Sep 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9029T CA Primary

Addresses

Primary practice location

12138 Firestone Blvd
Norwalk, CA 90650-4320

Mailing address

12138 Firestone Blvd
Norwalk, CA 90650-4320
Phone (562) 868-8233

Other identifiers 1

IdentifierTypeStateIssuer
SD0090290MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9029CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
First Optometric Care of Northern California PC Optometrist Current Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
John Larcabal OD Optometrist PastSince Dec 9, 2010 Accepting new patients

Locations

12138 Firestone Blvd
Norwalk, CA 90650
Phone (562) 868-8233

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1639172273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12138 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504320",
            "telephone_number": "562-868-8233",
            "fax_number": "562-868-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12138 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504320",
            "telephone_number": "562-868-8233",
            "fax_number": "562-868-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARCABAL",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9029T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0090290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.