Active NPI
Kenneth A Kronick, O.D.
- Optometrist
- Los Angeles, CA
National Provider Identifier
1659598316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5293T
- Practice address
- 12328 Washington PL
Suite B
Los Angeles, CA 90066-4923 - Phone
- (310) 397-0857
- Fax
- (310) 313-2020
- NPI assigned
- Apr 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5293T | CA | Primary |
Addresses
Primary practice location
12328 Washington PL
Suite B
Los Angeles, CA 90066-4923
Mailing address
12328 Washington PL
Suite B
Los Angeles, CA 90066-4923
Phone (310) 397-0857
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 |
|---|---|---|---|
| 5293T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659598316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12328 WASHINGTON PL",
"address_2": "SUITE B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900664923",
"telephone_number": "310-397-0857",
"fax_number": "310-313-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12328 WASHINGTON PL",
"address_2": "SUITE B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900664923",
"telephone_number": "310-397-0857",
"fax_number": "310-313-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRONICK",
"first_name": "KENNETH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5293T",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.