Active NPI
Sidney John Wiley, O.D.
- Optometrist
- Lompoc, CA
National Provider Identifier
1881627768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- BOL 6387
- Practice address
- 1305 N H St
Suite E
Lompoc, CA 93436-8138 - Phone
- (805) 736-3488
- Fax
- (805) 737-0346
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | BOL 6387 | CA | Primary |
Addresses
Primary practice location
1305 N H St
Suite E
Lompoc, CA 93436-8138
Mailing address
1305 N H St
Suite E
Lompoc, CA 93436-8138
Phone (805) 736-3488
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 |
|---|---|---|---|
| BOL 6387 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881627768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 N H ST",
"address_2": "SUITE E",
"city": "LOMPOC",
"state": "CA",
"postal_code": "934368138",
"telephone_number": "805-736-3488",
"fax_number": "805-737-0346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 N H ST",
"address_2": "SUITE E",
"city": "LOMPOC",
"state": "CA",
"postal_code": "934368138",
"telephone_number": "805-736-3488",
"fax_number": "805-737-0346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "SIDNEY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "BOL 6387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lompoc, CA
Sources for this page
- 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.