Logan Optometrics, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

OPT 10365 TPA Issued in CA

Legal business name

LOGAN OPTOMETRICS, INC.

Practice address

9186 W Pico Blvd
Los Angeles, CA 90035-1320

Phone

(310) 276-1702

Fax

(310) 276-9715

NPI assigned

Jan 2, 2014

Organization subpart

No

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

Authorized official

Name

Maiya Logan, D.O.NPI 1427195189

Title

Owner

Phone

(310) 276-1702

Specialties & licenses 1

Addresses

Other names 1

• PICO OPTOMETRY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maiya Logan, O.D.

  • Optometrist
  • Torrance, CA
  • NPI 1427195189
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1700207115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9186 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351320",
            "telephone_number": "310-276-1702",
            "fax_number": "310-276-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9186 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351320",
            "telephone_number": "310-276-1702",
            "fax_number": "310-276-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN OPTOMETRICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MAIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-276-1702",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "OPT 10365 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PICO OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daijah Monea Lofton
• Tammy P. Lofton
• Katherine Loftus
• Lindsey Loftus, M.S.
• Amir N. Lofty, MD
• Logan Wellness Advanced Nursing Practice Corp
• Anthony Louis Logan II
• Bryon Logan
• Deborah Lorraine Logan
• Deirdre Dene Logan, M.D.

• Eyewear Supplier in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.