Arrow Vision Center Optometry, a Professional Corp
Organization Active NPI Optometrist · Glendora, CA
NPI 1689609257 · NPPES record last updated Mar 25, 2015
Key facts
- NPI
- 1689609257
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 8672 TPL (CA)
- Legal business name
- ARROW VISION CENTER OPTOMETRY, A PROFESSIONAL CORP
- Practice address
- 601 W Arrow Hwy
Glendora, CA 91740-5411 - Phone
- (626) 914-2414
- Fax
- (626) 335-2635
- NPI assigned
- Jul 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Eric A Bettelheim, O.D.
- Title
- President
- Phone
- (626) 914-2414
Corporate family (same tax ID) 1
Practitioners 2
-
Eric A Bettelheim, O.D.
-
Michele Choi, O.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2159768 | Arrow Vision Center Optometry | Certificate of waiver | Dec 25, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050222000974 | CA | Part B Supplier - Clinic/Group Practice | 3375596091 |
Receives reassigned benefits from 2 practitioners Practice locations: Glendora, CA |
National Provider Directory
- Tax ID family
- Arrow Vision Center Optometry
Locations
601 W Arrow Hwy
Glendora, CA 91740
Phone (626) 914-2414
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 8672 TPL | CA | Yes |
Addresses
Primary practice location
601 W Arrow Hwy
Glendora, CA 91740-5411
Mailing address
601 W Arrow Hwy
Glendora, CA 91740-5411
Phone (626) 914-2414
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GSD004990 | Medicaid | CA |
Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.