Organization Active NPI

Arthur Friedman OD a Professional Optometric Corporation

  • Optometrist
  • San Bernardino, CA
National Provider Identifier
1679628069
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT6922T Issued in CA
Legal business name
ARTHUR FRIEDMAN OD A PROFESSIONAL OPTOMETRIC CORPORATION
Practice address
2150 N Waterman Ave
#201
San Bernardino, CA 92404-4811
Phone
(909) 881-2020
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Authorized official

Name
Dr. Arthur Friedman, O.D.NPI 1033195888
Title
Owner
Phone
(909) 881-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT6922T CA Primary

Addresses

Primary practice location

2150 N Waterman Ave
#201
San Bernardino, CA 92404-4811

Mailing address

2150 N Waterman Ave
#201
San Bernardino, CA 92404-4811
Phone (909) 881-2020

Other identifiers 1

IdentifierTypeStateIssuer
GSD003000MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611000974 CA Part B Supplier - Clinic/Group Practice 9830172543 Receives reassigned benefits from 4 practitioners
Practice locations: San Bernardino, CA

National Provider Directory

National Provider Directory
Tax ID family
Arthur Friedman OD a Professional Optometric Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7890 Haven Ave
Ste 17
Rch Cucamonga, CA 91730
Phone (909) 987-3330

130 Carousel Mall
San Bernardino, CA 92401
Phone (909) 888-3226

265 Carousel Mall
San Bernardino, CA 92401
Phone (909) 888-3266

2150 N Waterman Ave
Ste 201
Sn Bernrdno, CA 92404
Phone (909) 717-9636

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1679628069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE",
            "address_2": "#201",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044811",
            "telephone_number": "909-881-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 N WATERMAN AVE",
            "address_2": "#201",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044811",
            "telephone_number": "909-881-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTHUR FRIEDMAN OD A PROFESSIONAL OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-881-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT6922T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD003000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.