Robert Randal Edwards, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6206 Issued in CA

Practice address

951 N Milliken Ave
Inside Sam'S Club
Ontario, CA 91764-5008

Phone

(909) 481-9801

Fax

(909) 987-4956

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. R. Randal Edwards Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1700937489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 N MILLIKEN AVE",
            "address_2": "INSIDE SAM'S CLUB",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645008",
            "telephone_number": "909-481-9801",
            "fax_number": "909-987-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N MILLIKEN AVE",
            "address_2": "INSIDE SAM'S CLUB",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917645008",
            "telephone_number": "909-481-9801",
            "fax_number": "909-987-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ROBERT",
        "middle_name": "RANDAL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R.",
            "last_name": "EDWARDS",
            "middle_name": "RANDAL",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nevaeh Echeverria
• Wende Eddington
• Tenuri Edirimuni
• Jade Edwards
• Nolan Edwards
• Shonnette Edwards
• Eggleston Youth Centers, Inc.
• Lorena Eguia
• Michael Bryant Ehrig, MFTI
• Linda D Ekeomodi, RPH

• Optometrist in Ontario, CA
• Providers in Ontario, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.