Individual provider Active NPI

Stephen Haddad, BCO, BADO

  • Ocularist
  • Los Angeles, CA
National Provider Identifier
1689442477
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
Practice address
321 N Larchmont Blvd Ste 711
Los Angeles, CA 90004-6407
Phone
(323) 462-6004
Fax
(323) 462-4939
NPI assigned
Dec 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ocularist 156FX1700X Primary

Addresses

Primary practice location

321 N Larchmont Blvd Ste 711
Los Angeles, CA 90004-6407

Mailing address

321 N Larchmont Blvd Ste 711
Los Angeles, CA 90004-6407
Phone (323) 462-6004

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ocular Prosthetics, Inc. Ocularist CurrentSince Dec 17, 2023 Accepting new patients
Ocular Prosthetics, Inc. Ocularist CurrentSince Dec 17, 2023 Accepting new patients

Locations

321 N Larchmont Blvd
Ste 711
Los Angeles, CA 90004
Phone (323) 462-6004

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": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1689442477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N LARCHMONT BLVD STE 711",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900046407",
            "telephone_number": "323-462-6004",
            "fax_number": "323-462-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N LARCHMONT BLVD STE 711",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900046407",
            "telephone_number": "323-462-6004",
            "fax_number": "323-462-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "STEPHEN",
        "credential": "BCO, BADO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "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 Feb 12, 2024; 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.