Santa Monica Eye Medical Group

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G6556 Issued in CA

Legal business name

SANTA MONICA EYE MEDICAL GROUP

Practice address

1908 Santa Monica Blvd
Suite 3
Santa Monica, CA 90404-1927

Phone

(310) 829-5475

Fax

(310) 828-1359

NPI assigned

Mar 12, 2007

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

Sheila D Siegal

Title

Office Manager

Phone

(310) 829-5475

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DONALD E DICKERSON MD Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881726198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 SANTA MONICA BLVD",
            "address_2": "SUITE 3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041927",
            "telephone_number": "310-829-5475",
            "fax_number": "310-828-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 SANTA MONICA BLVD",
            "address_2": "SUITE 3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041927",
            "telephone_number": "310-829-5475",
            "fax_number": "310-828-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MONICA EYE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIEGAL",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "310-829-5475"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G6556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ348612",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DONALD E DICKERSON MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Santa Monica Bay Physicians
• Santa Monica Black Lives Association (Santa Monica Black Empowerment Association (SMBEA))
• Santa Monica Collective Mind Inc (Center for Integrative Counseling and Coaching)
• Santa Monica Dermatology Group
• Santa Monica Detox
• Santa Monica Gynecological and Obstectrical Medical Group Incorporated
• Santa Monica Hand Therapy, Inc.
• Santa Monica Homeopathic Phy (Santa Monica Homeopathic Pharmacy)
• Santa Monica Hospice, Inc.
• Santa Monica Malibu Unified School

• Ophthalmology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Ophthalmology Physician 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.