Maylin Gonzalez OD an Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MAYLIN GONZALEZ OD AN OPTOMETRIC CORPORATION

Practice address

12222 Wilshire Blvd
Suite 105
Los Angeles, CA 90025-1173

Phone

(424) 208-3107

Fax

(424) 208-3065

NPI assigned

Dec 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Maylin Gonzalez, O.D.NPI 1447460472

Title

President/Owner

Phone

(424) 208-3107

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Maylin Gonzalez, O.D.

  • Optometrist
  • Los Angeles, CA
  • NPI 1447460472
  NPD Authorized official

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1811233984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12222 WILSHIRE BLVD",
            "address_2": "SUITE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251173",
            "telephone_number": "424-208-3107",
            "fax_number": "424-208-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 WILSHIRE BLVD",
            "address_2": "SUITE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251173",
            "telephone_number": "424-208-3107",
            "fax_number": "424-208-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYLIN GONZALEZ OD AN OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MAYLIN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "424-208-3107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.