Active NPI
Brannon Halim, OD
- Optometrist
- Vallejo, CA
National Provider Identifier
1811653942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 35070
- Practice address
- 173 Plaza Dr Ste 1009
Vallejo, CA 94591-3708 - Phone
- (707) 917-4053
- NPI assigned
- Nov 12, 2021
- Last updated
- Jan 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 35070 | CA | Primary |
Addresses
Primary practice location
173 Plaza Dr Ste 1009
Vallejo, CA 94591-3708
Mailing address
1015 Victoria Park
Hercules, CA 94547-2637
Phone (805) 551-5069
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35070 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Vision, Inc. | Current | Accepting new patients |
Locations
173 Plaza Dr
Ste 1009
Vallejo, CA 94591
Phone (707) 917-4053
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643241600000",
"number": "1811653942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 VICTORIA PARK",
"city": "HERCULES",
"state": "CA",
"postal_code": "945472637",
"telephone_number": "805-551-5069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "173 PLAZA DR STE 1009",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945913708",
"telephone_number": "707-917-4053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALIM",
"first_name": "BRANNON",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-12",
"last_updated": "2022-01-27",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "35070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.