Stephen J Moffett OD a Professional

Primary specialty

OptometristTaxonomy code 152W00000X

License

11550T Issued in CA

Legal business name

STEPHEN J MOFFETT OD A PROFESSIONAL

Practice address

950 Orange Ave
Coronado, CA 92118-2610

Phone

(619) 435-6221

Fax

(619) 435-6289

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephen J Moffett, OD A PROFESSIONALNPI 1467584102

Title

President

Phone

(619) 435-6221

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

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

• Stephen Joseph Moffett, O.D. APC

  • Optometrist
  • Coronado, CA
  • NPI 1467584102
  Medicare reassignment Authorized official
• Robert Michael Howard, OD

  • Optometrist
  • San Diego, CA
  • NPI 1912977554
  NPD
• Melanie Zenor, DACM, LAC

  • Acupuncturist
  • La Jolla, CA
  • NPI 1891595591
  NPD
• Kerry Lynn Keiser, D.C.

  • Chiropractor
  • San Diego, CA
  • NPI 1497957302
  NPD (past)
• Ronald Michael Rosa, O.D

  • Optometrist
  • Encinitas, CA
  • NPI 1194084871
  NPD (past)

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730592000000",
    "number": "1669651980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 ORANGE AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921182610",
            "telephone_number": "619-435-6221",
            "fax_number": "619-435-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 ORANGE AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921182610",
            "telephone_number": "619-435-6221",
            "fax_number": "619-435-6289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 N El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920242863",
            "country_code": "US",
            "telephone_number": "760-634-1957",
            "fax_number": "760-634-1994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STEPHEN J MOFFETT OD A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A",
        "authorized_official_last_name": "MOFFETT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-435-6221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD A PROFESSIONAL"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11550T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern California Liver Centers Inc
• Krystle Aguilar Stadler
• Scott A Stearns
• Cory Stege, LMFT
• Stephen H Dao DDS PC
• Paula Stonehouse
• Strength in Service
• Strength in Service
• Jacquelyn Summers, PH.D., MPH, MSW
• Stephen Sun, DO

• Optometrist in Coronado, CA
• Providers in Coronado, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.