Doris Boudaie, OD

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

10992 Issued in CA

Practice address

8500 Beverly Blvd
Los Angeles, CA 90048-6201

Phone

(310) 360-3937

Fax

(310) 360-3928

NPI assigned

May 19, 2015

Last updated

Oct 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doris Boudaie Optometric

  • Optometrist
  • Los Angeles, CA
  • NPI 1477005973
  NPD (past) Authorized official

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1811376205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 S BEVERLY DR STE 333",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123810",
            "telephone_number": "310-360-3937",
            "fax_number": "310-360-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486201",
            "telephone_number": "310-360-3937",
            "fax_number": "310-360-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDAIE",
        "first_name": "DORIS",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10992T",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "10992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Boucher
• Jane Kim Boucher, PHARM.D.
• Michael Lewis Boucher, M.D.
• Raymond Bouchereau Jr.
• Alex Boudaie, DDS
• Samantha Boudaie
• Christopher V Boudakian, D.O.
• Susan K. Boudakian, DO
• Elizabeth Michelle Boudiab, MD
• John Boudreau

• Corneal and Contact Management Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Corneal and Contact Management Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.