Individual provider Active NPI

Slawomir Zmijewski

  • Optician
  • San Diego, CA
National Provider Identifier
1780972158
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
00005564 Issued in CA
Practice address
1772 Garnet Ave Ste E
San Diego, CA 92109-3373
Phone
(858) 270-9320
NPI assigned
Jul 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 00005564 CA Primary

Addresses

Primary practice location

1772 Garnet Ave Ste E
San Diego, CA 92109-3373

Mailing address

1772 Garnet Ave Ste E
San Diego, CA 92109-3373
Phone (858) 270-9320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00005564CAMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1780972158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 GARNET AVE STE E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093373",
            "telephone_number": "858-270-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 GARNET AVE STE E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093373",
            "telephone_number": "858-270-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZMIJEWSKI",
        "first_name": "SLAWOMIR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "00005564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.