Corben Optometry Inc
Organization Active NPI Optometrist · Newhall, CA
NPI 1801910096 · NPPES record last updated Jul 22, 2020
Key facts
- NPI
- 1801910096
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 4954T (CA)
- Legal business name
- CORBEN OPTOMETRY INC
- Practice address
- 23206 Lyons Ave Ste 102
Newhall, CA 91321-2671 - Phone
- (661) 259-2168
- Fax
- (661) 259-3568
- NPI assigned
- Mar 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Joshua Adam Corben, O.D.
- Title
- V.P.
- Phone
- (661) 259-2168
Practitioners 6
-
Joshua Adam Corben, O.D.
-
Michael A Corben, O.D.
-
Sheila Tehrani, O.D.
-
Matthew R Alpert, O.D.
-
Amy Wingshan Lam, O.D.
-
Mann Trinh, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080111000481 | CA | Part B Supplier - Clinic/Group Practice | 2365523735 |
Receives reassigned benefits from 3 practitioners Practice locations: Newhall, CA |
National Provider Directory
Locations
23206 Lyons Ave
Ste 102
Newhall, CA 91321
Phone (661) 259-2168
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 4954T | CA | Yes |
Addresses
Primary practice location
23206 Lyons Ave Ste 102
Newhall, CA 91321-2671
Mailing address
23206 Lyons Ave Ste 102
Newhall, CA 91321-2671
Phone (661) 259-2168
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912011560 | Other | CA | NPI |
| 1043297666 | Other | CA | NPI INDIVIDUAL |
Other providers in Newhall, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.