Active NPI
Donny V. Wilson
- Optometrist
- Pasadena, CA
National Provider Identifier
1790621803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1234
- Practice address
- 100 S Greenwood Ave Apt 4
Pasadena, CA 91107-4702 - Phone
- (951) 478-7087
- NPI assigned
- Apr 29, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1234 | CA | Primary |
Addresses
Primary practice location
100 S Greenwood Ave Apt 4
Pasadena, CA 91107-4702
Mailing address
100 S Greenwood Ave Apt 4
Pasadena, CA 91107-4702
Phone (951) 478-7087
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1234 | CA | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777420800000",
"number": "1790621803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 S GREENWOOD AVE APT 4",
"city": "PASADENA",
"state": "CA",
"postal_code": "911074702",
"telephone_number": "951-478-7087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S GREENWOOD AVE APT 4",
"city": "PASADENA",
"state": "CA",
"postal_code": "911074702",
"telephone_number": "951-478-7087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DONNY",
"middle_name": "V.",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-29",
"last_updated": "2026-04-29",
"certification_date": "2026-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "1234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.