Booth Optometry Group

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-11505-TPA Issued in CA

Legal business name

BOOTH OPTOMETRY GROUP

Practice address

1102 Irvine Blvd
Tustin, CA 92780-3529

Phone

(714) 838-3210

Fax

(714) 838-5702

NPI assigned

Jun 23, 2011

Organization subpart

No

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

Authorized official

Name

Amy Louise Kayekjian, O.D.NPI 1992912935

Title

Optometrist

Phone

(714) 838-3210

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Louise Kayekjian, OD

  • Optometrist
  • Chapin, SC
  • NPI 1992912935
  NPD (past) Authorized official

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1861788218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803529",
            "telephone_number": "714-838-3210",
            "fax_number": "714-838-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803529",
            "telephone_number": "714-838-3210",
            "fax_number": "714-838-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTH OPTOMETRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "KAYEKJIAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "714-838-3210",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT-11505-TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0115050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryleh Morgan Bones
• Eva Boni
• Debra Anne Bonnefin, DC
• Heather Kristina Bonnville, PHYSICIAN ASSISTANT
• Stephanie Boone, LMFT
• Lowell John Booth, OD
• Stephanie Bornstein
• Robert J Borrowdale, M.D.
• Boskovic & Srbinovska DDS Inc
• Boskovic Srbinovska DDS Inc.

• Optometrist in Tustin, CA
• Providers in Tustin, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.