NPIMap

Organization Active NPI

Eye Care for Diabetics Medical Group, Inc

  • Exclusive Provider Organization
  • Inglewood, CA
National Provider Identifier
1871738971
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
A30576 Issued in CA
Legal business name
EYE CARE FOR DIABETICS MEDICAL GROUP, INC
Practice address
323 N Prairie Ave
Suite 217
Inglewood, CA 90301-4502
Phone
(310) 671-0909
Fax
(310) 412-0066
NPI assigned
Dec 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Authorized official

Name
Mr. Leroy W Vaughn Sr., MD
Title
President/Owner
Phone
(310) 671-0909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X A30576 CA Primary

Addresses

Primary practice location

323 N Prairie Ave
Suite 217
Inglewood, CA 90301-4502

Mailing address

323 N Prairie Ave
Suite 217
Inglewood, CA 90301-4502
Phone (310) 671-0909

National Provider Directory

National Provider Directory
Tax ID family
Eye Care for Diabetics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1871738971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE",
            "address_2": "SUITE 217",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014502",
            "telephone_number": "310-671-0909",
            "fax_number": "310-412-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE",
            "address_2": "SUITE 217",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014502",
            "telephone_number": "310-671-0909",
            "fax_number": "310-412-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE FOR DIABETICS MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "310-671-0909",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "A30576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.