Organization Active NPI

Friedman Optometry, Inc.

  • Optometrist
  • Culver City, CA
National Provider Identifier
1700409810
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FRIEDMAN OPTOMETRY, INC.
Practice address
10724 Washington Blvd
Culver City, CA 90232-3314
Phone
(310) 559-0500
Fax
(310) 559-4009
NPI assigned
May 22, 2020
Last updated
May 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Authorized official

Name
Stacy Alvarez
Title
Billing Manager
Phone
(310) 508-0836

Specialties & licenses 1

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

Addresses

Primary practice location

10724 Washington Blvd
Culver City, CA 90232-3314

Mailing address

25317 Doria Ave
Lomita, CA 90717-1721
Phone (310) 508-0836

Other identifiers 1

IdentifierTypeStateIssuer
1285710939OtherCAOPTOMETRY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210309001776 CA Part B Supplier - Clinic/Group Practice 9133535578 Receives reassigned benefits from 4 practitioners
Practice locations: Culver City, CA

National Provider Directory

National Provider Directory

Locations

10724 Washington Blvd
Culver City, CA 90232
Phone (310) 559-0500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1700409810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25317 DORIA AVE",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907171721",
            "telephone_number": "310-508-0836",
            "fax_number": "310-559-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10724 WASHINGTON BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323314",
            "telephone_number": "310-559-0500",
            "fax_number": "310-559-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIEDMAN OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "310-508-0836"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY",
            "identifier": "1285710939",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.