Organization Active NPI

RL Evans, Ma Carter Professional Corporation

  • Optometrist
  • El Cajon, CA
National Provider Identifier
1700050986
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4790T Issued in CA
Legal business name
RL EVANS, MA CARTER PROFESSIONAL CORPORATION
Practice address
510 S Magnolia Ave
El Cajon, CA 92020-6011
Phone
(619) 444-9012
Fax
(619) 444-0232
NPI assigned
Apr 17, 2008
Organization subpart
No

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

Authorized official

Name
Dr. Marilyn A. Carter, OD
Title
Owner / Optometrist
Phone
(619) 444-9012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4790T CA Primary

Addresses

Primary practice location

510 S Magnolia Ave
El Cajon, CA 92020-6011

Mailing address

510 S Magnolia Ave
El Cajon, CA 92020-6011
Phone (619) 444-3012

Other identifiers 1

IdentifierTypeStateIssuer
OP4790MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
RL Evans Ma Carter Professional 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

510 S Magnolia Ave
El Cajon, CA 92020
Phone (619) 422-5361

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1700050986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S MAGNOLIA AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920206011",
            "telephone_number": "619-444-3012",
            "fax_number": "619-444-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S MAGNOLIA AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920206011",
            "telephone_number": "619-444-9012",
            "fax_number": "619-444-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RL EVANS, MA CARTER PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER / OPTOMETRIST",
        "authorized_official_telephone_number": "619-444-9012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "4790T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OP4790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.