Active NPI
Maia J Budnero, O.D.
- Optometrist
- Glendale, CA
National Provider Identifier
1649505611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 13847 TLG
- Practice address
- 330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308 - Phone
- (818) 240-0890
- Fax
- (818) 246-2540
- NPI assigned
- Oct 8, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT 13847 TLG | CA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | OPT 13847 TLG | CA |
Addresses
Primary practice location
330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308
Mailing address
330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308
Phone (818) 240-0890
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13847 | CA | MD | Professional Counselor |
| OPT 13847 TLG | CA | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254960000000",
"number": "1649505611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 N BRAND BLVD",
"address_2": "SUITE 110",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912032308",
"telephone_number": "818-240-0890",
"fax_number": "818-246-2540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N BRAND BLVD",
"address_2": "SUITE 110",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912032308",
"telephone_number": "818-240-0890",
"fax_number": "818-246-2540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUDNERO",
"first_name": "MAIA",
"middle_name": "J",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-08",
"last_updated": "2009-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 13847 TLG",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "OPT 13847 TLG",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.