Organization Active NPI

Roshanak Nasr O.D. a Professional Corporation

  • Optometrist
  • Downey, CA
National Provider Identifier
1790222909
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11928TLG Issued in CA
Legal business name
ROSHANAK NASR O.D. A PROFESSIONAL CORPORATION
Practice address
9418 Firestone Blvd
Downey, CA 90241-5504
Phone
(562) 869-3937
NPI assigned
Jan 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Authorized official

Name
Roshanak Nasr, OD
Title
President
Phone
(714) 606-5505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 11928TLG CA Primary

Addresses

Primary practice location

9418 Firestone Blvd
Downey, CA 90241-5504

Mailing address

9418 Firestone Blvd
Downey, CA 90241-5504
Phone (562) 869-3937

Other identifiers 1

IdentifierTypeStateIssuer
11928TLGOtherCAOPTOMETRIC LICENSE

National Provider Directory

National Provider Directory

Locations

9418 Firestone Blvd
Downey, CA 90241
Phone (562) 869-3937

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1790222909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9418 FIRESTONE BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415504",
            "telephone_number": "562-869-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9418 FIRESTONE BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415504",
            "telephone_number": "562-869-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSHANAK NASR O.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "NASR",
        "authorized_official_first_name": "ROSHANAK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-606-5505",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11928TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIC LICENSE",
            "identifier": "11928TLG",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.