Active NPI
Batoul Moradzadeh
- Optometrist
- San Bernardino, CA
National Provider Identifier
1861108011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 35154
- Practice address
- 330 Inland Ctr
San Bernardino, CA 92408-1956 - Phone
- (909) 884-5255
- NPI assigned
- Jan 30, 2023
- Last updated
- Jan 30, 2023
- Sex
- Female
- 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 | 35154 | CA | Primary |
Addresses
Primary practice location
330 Inland Ctr
San Bernardino, CA 92408-1956
Mailing address
76 Anacapa CT
Foothill Ranch, CA 92610-2436
Phone (714) 261-4441
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 |
|---|---|---|---|
| 35154 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675036800000",
"number": "1861108011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 ANACAPA CT",
"city": "FOOTHILL RANCH",
"state": "CA",
"postal_code": "926102436",
"telephone_number": "714-261-4441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 INLAND CTR",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924081956",
"telephone_number": "909-884-5255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORADZADEH",
"first_name": "BATOUL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-30",
"last_updated": "2023-01-30",
"certification_date": "2023-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "35154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.