Mark Raymond Stinson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6361 Issued in CA

Practice address

7291 Boulder Ave
2D
Highland, CA 92346-3389

Phone

(909) 425-1212

Fax

(909) 425-2485

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831242452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 CAMELOT DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923746457",
            "telephone_number": "909-793-2294",
            "fax_number": "909-425-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7291 BOULDER AVE",
            "address_2": "2D",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463389",
            "telephone_number": "909-425-1212",
            "fax_number": "909-425-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINSON",
        "first_name": "MARK",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Highland, CA
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.