L Edward Elliott Et Al PTR Elliott L Edward Gen PTR

Primary specialty

OptometristTaxonomy code 152W00000X

License

FNP88 Issued in CA

Legal business name

L EDWARD ELLIOTT ET AL PTR ELLIOTT L EDWARD GEN PTR

Practice address

3601 Coffee Rd
Modesto, CA 95355

Phone

(209) 521-1028

Fax

(209) 521-7488

NPI assigned

Nov 27, 2006

Last updated

Feb 1, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. L Edward Elliott, ODNPI 1023000502

Title

Doctor of Optometry

Phone

(209) 521-1028

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 5

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.

• L. Edward Elliott, O.D.

  • Corneal and Contact Management Optometrist
  • Escalon, CA
  • NPI 1023000502
  Medicare reassignment NPD Authorized official
• Brian Edward Elliott, O.D.

  • Optometrist
  • Riverbank, CA
  • NPI 1760566434
  Medicare reassignment NPD
• Neelam Thiara, DOCTOR OF OPTOMETRY

  • Optometrist
  • Tracy, CA
  • NPI 1477108421
  Medicare reassignment NPD
• Cecilia Sze Ka Tong, O.D.

  • Optometrist
  • Modesto, CA
  • NPI 1598107195
  Medicare reassignment NPD
• Garrett William Elliott, OD

  • Optometrist
  • Modesto, CA
  • NPI 1427710706
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1760558498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-521-1028",
            "fax_number": "209-521-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-521-1028",
            "fax_number": "209-521-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L EDWARD ELLIOTT ET AL PTR ELLIOTT L EDWARD GEN PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "L",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "DOCTOR OF OPTOMETRY",
        "authorized_official_telephone_number": "209-521-1028",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "FNP88",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Kwong, PHARMD
• Sara J Kwong, MD
• Kyle Heron MD PC
• Becca Kysar
• Natasha Kyte, M.D.
• L J Popat Dental Corporation (Divine Dental Studio)
• La Laser Center PC, a Professional Medical Corporation (Modesto Dermatology & Skin Cancer)
• La Tanya Takla, Psychologist Inc (Mending Feelings)
• Holly Lackey
• Tiffany Lackey

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.