Dr B Kamkar OD a Professional Optometry Corp

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT8512TLG Issued in CA

Legal business name

DR B KAMKAR OD A PROFESSIONAL OPTOMETRY CORP

Doing business as

Modern Optometry

Practice address

1104 E Colorado St
Glendale, CA 91205-1309

Phone

(818) 500-8008

Fax

(818) 500-8075

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Babak Kamkar, O.D., Q.M.E.NPI 1801892450

Title

Ceo, Owner, Doctor

Phone

(818) 500-8008

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• MODERN OPTOMETRY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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.

• Babak Kamkar, O.D., Q.M.E.

  • Optometrist
  • Glendale, CA
  • NPI 1801892450
  Medicare reassignment Care Compare group NPD Authorized official
• Jasmina Koprivica, OD

  • Optometrist
  • Claremont, CA
  • NPI 1346211158
  Medicare reassignment Care Compare group NPD
• Irina Yakubin

  • Optometrist
  • Santa Monica, CA
  • NPI 1033715990
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1710190251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051309",
            "telephone_number": "818-500-8008",
            "fax_number": "818-500-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051309",
            "telephone_number": "818-500-8008",
            "fax_number": "818-500-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR B KAMKAR OD A PROFESSIONAL OPTOMETRY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "KAMKAR",
        "authorized_official_first_name": "BABAK",
        "authorized_official_title_or_position": "CEO, OWNER, DOCTOR",
        "authorized_official_telephone_number": "818-500-8008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D., Q.M.E."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8512TLG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "OPT8512TLG",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "OPT8512TLG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "OPT8512TLG",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "OPT8512TLG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0085121",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MODERN OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.