Individual provider Active NPI

Christopher Edwin Vargas, O.D.

  • Optometrist
  • Anaheim, CA
National Provider Identifier
1699845537
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11770T Issued in CA
Practice address
947 S Anaheim Blvd Ste 230
Anaheim, CA 92805-5591
Phone
(714) 491-0881
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11770T CA Primary

Addresses

Primary practice location

947 S Anaheim Blvd Ste 230
Anaheim, CA 92805-5591

Mailing address

947 S Anaheim Blvd Ste 230
Anaheim, CA 92805-5591
Phone (714) 491-0881

Other identifiers 1

IdentifierTypeStateIssuer
SD0117700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906000533 CA Practitioner - Optometry 2769414234 Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11770TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1699845537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 S ANAHEIM BLVD STE 230",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928055591",
            "telephone_number": "714-491-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 S ANAHEIM BLVD STE 230",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928055591",
            "telephone_number": "714-491-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "CHRISTOPHER",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11770T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0117700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.