Lowell John Booth, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT4984 TPL Issued in CA

Practice address

1102 Irvine Blvd
Tustin, CA 92780-3529

Phone

(714) 838-3210

Fax

(714) 838-5702

NPI assigned

Jan 19, 2006

Last updated

Jan 23, 2009By the provider in NPPES

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1750361424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803529",
            "telephone_number": "714-838-3210",
            "fax_number": "714-838-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803529",
            "telephone_number": "714-838-3210",
            "fax_number": "714-838-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "LOWELL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT4984 TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MESC",
            "identifier": "3108",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0049840",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VBA",
            "identifier": "4984T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eva Boni
• Debra Anne Bonnefin, DC
• Heather Kristina Bonnville, PHYSICIAN ASSISTANT
• Stephanie Boone, LMFT
• Booth Optometry Group
• Stephanie Bornstein
• Robert J Borrowdale, M.D.
• Boskovic & Srbinovska DDS Inc
• Boskovic Srbinovska DDS Inc.
• Milos M. Boskovic, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.