Severance Optometric Center,Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SEVERANCE OPTOMETRIC CENTER,INC

Practice address

3030 W Olympic Blvd Ste 110
Los Angeles, CA 90006-6504

Phone

(213) 487-4488

Fax

(213) 487-4908

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Steven I Bai, O.D.NPI 1497858930

Title

Ceo

Phone

(213) 487-4488

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Steven I. Bai, O.D.

  • Optometrist
  • Los Angeles, CA
  • NPI 1497858930
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1710166210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 W OLYMPIC BLVD STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900066504",
            "telephone_number": "213-487-4488",
            "fax_number": "213-487-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W OLYMPIC BLVD STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900066504",
            "telephone_number": "213-487-4488",
            "fax_number": "213-487-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVERANCE OPTOMETRIC CENTER,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "BAI",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-487-4488",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brett John Sevilla, M.D.
• Cecilia Sevilla, RN
• Louise Sevilla, LCSW

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.