NPIMap

Organization Active NPI

David B Rosenblum O D Inc

  • Optometrist
  • Cerritos, CA
National Provider Identifier
1720239288
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10235T Issued in CA
Legal business name
DAVID B ROSENBLUM O D INC
Practice address
11805 South St
Cerritos, CA 90703-6825
Phone
(562) 860-4475
Fax
(562) 924-3526
NPI assigned
Oct 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Heidi QT Pham-Murphy, OD
Title
President
Phone
(949) 640-4473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10235T CA Primary

Addresses

Primary practice location

11805 South St
Cerritos, CA 90703-6825

Mailing address

11805 South St
Cerritos, CA 90703-6825
Phone (562) 860-4475

Other names 1

  • Eyesite Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140213001102 CA Part B Supplier - Clinic/Group Practice 1153550264 Receives reassigned benefits from 9 practitioners
Practice locations: Cerritos, CA; Newport Coast, CA

National Provider Directory

National Provider Directory
Tax ID family
David B Rosenblum O D Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

21161 Newport Coast Dr
Newport Beach, CA 92657
Phone (949) 640-4733

Practitioners & affiliated clinicians

Practitioners 10

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": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1720239288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11805 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036825",
            "telephone_number": "562-860-4475",
            "fax_number": "562-924-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11805 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036825",
            "telephone_number": "562-860-4475",
            "fax_number": "562-924-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID B ROSENBLUM O D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "PHAM-MURPHY",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "QT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-640-4473",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10235T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyesite Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.