Individual provider Active NPI

Alan H. Leventhal, OD

  • Optometrist
  • Baldwin Park, CA
National Provider Identifier
1669409710
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6075 TPA Issued in CA
Practice address
14461 Merced Ave Ste 101
Baldwin Park, CA 91706-5173
Phone
(626) 939-4588
Fax
(626) 939-4590
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6075 TPA CA Primary

Addresses

Primary practice location

14461 Merced Ave Ste 101
Baldwin Park, CA 91706-5173

Mailing address

24707 Riverchase Dr Apt 7204
Valencia, CA 91355-1428
Phone (619) 507-6663

Other identifiers 1

IdentifierTypeStateIssuer
APPLIED FORMedicaidCA

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
6075 TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Primigenia Optometry Inc Optometrist PastSince Nov 1, 2012 Accepting new patients
Western Optometric Center Inc Optometrist PastSince Aug 6, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1669409710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24707 RIVERCHASE DR APT 7204",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551428",
            "telephone_number": "619-507-6663",
            "fax_number": "626-939-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14461 MERCED AVE STE 101",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065173",
            "telephone_number": "626-939-4588",
            "fax_number": "626-939-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENTHAL",
        "first_name": "ALAN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6075 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED FOR",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.