Organization Active NPI

Eric M. White OD, Inc

  • Corneal and Contact Management Optometrist
  • San Diego, CA
National Provider Identifier
1699987768
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
8611T Issued in CA
Legal business name
ERIC M. WHITE OD, INC
Practice address
5075 Ruffin Rd Ste B
San Diego, CA 92123-1698
Phone
(858) 278-4720
Fax
(858) 278-3640
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Authorized official

Name
Dr. Eric Milton White, ODNPI 1205808045
Title
Owner
Phone
(858) 278-4720

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
Corneal and Contact Management OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WC0802X 8611T CA Primary

Addresses

Primary practice location

5075 Ruffin Rd Ste B
San Diego, CA 92123-1698

Mailing address

5075 Ruffin Rd Ste B
San Diego, CA 92123-1698
Phone (858) 278-4720

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040917000485 CA Part B Supplier - Clinic/Group Practice 0244208320 Receives reassigned benefits from 4 practitioners
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

5075 Ruffin Rd
Ste B
San Diego, CA 92123
Phone (858) 274-9464

Practitioners & affiliated clinicians

Practitioners 6

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1699987768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 RUFFIN RD STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231698",
            "telephone_number": "858-278-4720",
            "fax_number": "858-278-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 RUFFIN RD STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231698",
            "telephone_number": "858-278-4720",
            "fax_number": "858-278-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC M. WHITE OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "MILTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-278-4720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "8611T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.