NPIMap

Organization Active NPI

Duane Decroupet OD a PC

  • Optometrist
  • Glendale, CA
National Provider Identifier
1730258476
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DUANE DECROUPET OD A PC
Practice address
308 E Broadway
Glendale, CA 91205
Phone
(818) 243-1300
Fax
(818) 243-1583
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Dr. Duane De Croupet, OD
Title
Owner Doctor
Phone
(818) 243-1300

Specialties & licenses 1

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

Addresses

Primary practice location

308 E Broadway
Glendale, CA 91205

Mailing address

308 E Broadway
Glendale, CA 91205
Phone (818) 243-1300

Other names 1

  • Glendale Optometric Center Doing business as

National Provider Directory

National Provider Directory

Locations

308 E Broadway
Glendale, CA 91205
Phone (818) 243-1300

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1730258476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-243-1300",
            "fax_number": "818-243-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-243-1300",
            "fax_number": "818-243-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUANE DECROUPET OD A PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "DE CROUPET",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "818-243-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glendale Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.