Active NPI
Devon Harris, RSLD
- Optician
- Los Angeles, CA
National Provider Identifier
1639704489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 41944
- Practice address
- 8900 Sepulveda Westway # 9985
Los Angeles, CA 90045-3619 - Phone
- (310) 242-4208
- NPI assigned
- Mar 11, 2020
- Last updated
- Mar 11, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 41944 | CA | Primary |
Addresses
Primary practice location
8900 Sepulveda Westway # 9985
Los Angeles, CA 90045-3619
Mailing address
11605 N Lamar Blvd
Austin, TX 78753-2658
Phone (737) 222-6996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41944 | CA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1639704489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11605 N LAMAR BLVD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787532658",
"telephone_number": "737-222-6996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8900 SEPULVEDA WESTWAY # 9985",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900453619",
"telephone_number": "310-242-4208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "DEVON",
"credential": "RSLD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-11",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "41944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.