Michaels Optical Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

D 3061 Issued in CA

Legal business name

MICHAELS OPTICAL INC.

Practice address

8300 El Camino Real
B
Atascadero, CA 93422-5358

Phone

(805) 466-5770

Fax

(805) 466-5801

NPI assigned

Sep 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael Gene Nutt

Title

President

Phone

(805) 466-5770

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841391174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 EL CAMINO REAL",
            "address_2": "B",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225358",
            "telephone_number": "805-466-5770",
            "fax_number": "805-466-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 EL CAMINO REAL",
            "address_2": "B",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225358",
            "telephone_number": "805-466-5770",
            "fax_number": "805-466-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAELS OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NUTT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-466-5770",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "D 3061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "ZZZ33213Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Douglass Mendenhall, FNP
• Yaneli Mendoza Torres
• Mary Beth Merola, OTR
• Darlene Maxfield Merrill, NURSE PRACTITIONER
• Jennifer M Metzler, DPT
• Kameren Mikkelsen
• Matthew Milburn, PSYD
• Charlotte Hennigar Milch, DDS
• Amber Lynn Miller
• Ann Marie Miller, MD, PHD

• Durable Medical Equipment & Medical Supplies in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.