Glendale Optometric Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

13022 Issued in CA

Legal business name

GLENDALE OPTOMETRIC CENTER

Practice address

308 E Broadway
Glendale, CA 91205-1011

Phone

(818) 243-1300

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stacey Tawnie Gin, O.D.NPI 1619085149

Title

Optometrist

Phone

(818) 243-1300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 14

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

• Stacey T. Gin, O.D.

  • Optometrist
  • Glendale, CA
  • NPI 1619085149
  Medicare reassignment Care Compare group NPD Authorized official
• Ani Muradian, OD

  • Optometrist
  • Pasadena, CA
  • NPI 1568987493
  Medicare reassignment Care Compare group NPD
• Jeffrey Teruo Nishi, O.D.

  • Optometrist
  • Glendale, CA
  • NPI 1588977847
  Medicare reassignment Care Compare group NPD
• Bonnie Chow Peng, OD

  • Optometrist
  • Monrovia, CA
  • NPI 1114968245
  Medicare reassignment Care Compare group NPD
• Jennifer Thy Le Huynh

  • Optometrist
  • Kent, WA
  • NPI 1881291185

  CA

  Medicare reassignment Care Compare group NPD
• Jacqueline Dang, OD

  • Optometrist
  • Pomona, CA
  • NPI 1770347502
  Medicare reassignment NPD
• Oanh Duong

  • Optometrist
  • Sepulveda, CA
  • NPI 1205531993
  Medicare reassignment NPD
• Jasmine Wong Yumori, O.D.

  • Optometrist
  • Pomona, CA
  • NPI 1427211473
  Medicare reassignment NPD
• Hermineh K Moradi, O.D.

  • Optometrist
  • Glendale, CA
  • NPI 1922298314
  NPD
• Esther Chung, O.D.

  • Low Vision Rehabilitation Optometrist
  • Glendale, CA
  • NPI 1356598288
  NPD (past)
• Diana Mihaela Ciobanu, O.D.

  • Optometrist
  • Mission Viejo, CA
  • NPI 1013002179
  NPD (past)
• Ani Halabi Khroyan, O.D.

  • Optometrist
  • Glendale, CA
  • NPI 1669584702
  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1801093653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051011",
            "telephone_number": "818-243-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051011",
            "telephone_number": "818-243-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE OPTOMETRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "GIN",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "TAWNIE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "818-243-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glendale Medical Imaging Associates Inc
• Glendale Multi-Specialty Surgery Center, LLC (Glendale Outpatient Surgery Center)
• Glendale Mutual Care Clinic
• Glendale Nephrology Services, LLC (Glendale Kidney Center)
• Glendale Ophthalmology ASC LP (Glendale Eye Surgery Center)
• Glendale Optometry
• Glendale Orthopaedics Inc.
• Glendale Pain Medicine Associates Inc (Tri-Valley Spine and Pain Centers)
• Glendale Pathology Associates Medical Group of Glendale
• Glendale Pediatrics, a Professional Corporation

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.