Larkspur Landing Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

10226T Issued in CA

Legal business name

LARKSPUR LANDING OPTOMETRIC CORPORATION

Practice address

2005 Larkspur Landing Cir
Larkspur, CA 94939-1802

Phone

(415) 925-9091

Fax

(415) 925-9092

NPI assigned

Jan 15, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Edward Ian Haack, O.D.NPI 1174516462

Title

Owner

Phone

(415) 925-9091

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Larkspur Landing Optometry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Haack, O.D.

  • Optometrist
  • Larkspur, CA
  • NPI 1174516462
  NPD (past) Authorized official

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1801033691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 LARKSPUR LANDING CIR",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 LARKSPUR LANDING CIR",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391802",
            "telephone_number": "415-925-9091",
            "fax_number": "415-925-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARKSPUR LANDING OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-15",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "HAACK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-925-9091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10226T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174516462",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1972725760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Larkspur Landing Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Alison Kreshin, MD
• Lindsey Kuroda, PT
• Kin Man Lai, MD
• Sarah M Lamb, RN, CNS, MS
• Sally Marie Blake Lamont, ND
• Larkspur Landing Optometry
• Donald L Lazzaretto, PHARM D
• Deborah Ann Leal, N.P-F
• Nicole Learned, M.D.
• John Sungchull Lee, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.