NPIMap

Organization Active NPI

Mountain Vista Optical

  • Eyewear Supplier
  • Redlands, CA
National Provider Identifier
1700900602
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
MOUNTAIN VISTA OPTICAL
Practice address
10 E State St
Redlands, CA 92373-4754
Phone
(951) 692-1323
Fax
(866) 258-0370
NPI assigned
Mar 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Patricia Thormahlen, OPTICAN
Title
President
Phone
(951) 692-1323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

10 E State St
Redlands, CA 92373-4754

Mailing address

PO Box 1431
San Jacinto, CA 92581-1431
Phone (951) 692-1323

National Provider Directory

National Provider Directory
Tax ID family
Mountain Vista Optical3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1174089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700900602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1431",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925811431",
            "telephone_number": "951-692-1323",
            "fax_number": "866-258-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E STATE ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734754",
            "telephone_number": "951-692-1323",
            "fax_number": "866-258-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VISTA OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THORMAHLEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-692-1323",
        "authorized_official_credential": "OPTICAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

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