Walnut Creek Eye Medical Group, Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

WALNUT CREEK EYE MEDICAL GROUP, INC

Practice address

1855 San Miguel Dr Ste 28
Walnut Creek, CA 94596-5298

Phone

(925) 935-8820

Fax

(925) 935-9542

NPI assigned

Apr 17, 2023

Organization subpart

No

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

Authorized official

Name

Levon Djenderedjian, MDNPI 1952756256

Title

Physician/Owner

Phone

(925) 935-8820

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Levon Djenderedjian, MD

  • Ophthalmology Physician
  • Walnut Creek, CA
  • NPI 1952756256
  NPD Authorized official

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1659067155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 SAN MIGUEL DR STE 28",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965298",
            "telephone_number": "925-935-8820",
            "fax_number": "925-935-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 SAN MIGUEL DR STE 28",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965298",
            "telephone_number": "925-935-8820",
            "fax_number": "925-935-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT CREEK EYE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "DJENDEREDJIAN",
        "authorized_official_first_name": "LEVON",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "925-935-8820",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.