Active NPI
Irene Pulido Lou, O.D.
- Optometrist
- San Bernardino, CA
National Provider Identifier
1891127858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 14734
- Practice address
- 4001 Hallmark Pkwy
#2
San Bernardino, CA 92407-1876 - Phone
- (909) 887-1881
- Fax
- (909) 887-8557
- NPI assigned
- Aug 1, 2013
- Sex
- Female
- 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 | 14734 | CA | Primary |
Addresses
Primary practice location
4001 Hallmark Pkwy
#2
San Bernardino, CA 92407-1876
Mailing address
4001 Hallmark Pkwy
#2
San Bernardino, CA 92407-1876
Phone (909) 887-1881
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14734 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Vision PC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427760000000",
"number": "1891127858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 HALLMARK PKWY",
"address_2": "#2",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924071876",
"telephone_number": "909-887-1881",
"fax_number": "909-887-8557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 HALLMARK PKWY",
"address_2": "#2",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924071876",
"telephone_number": "909-887-1881",
"fax_number": "909-887-8557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOU",
"first_name": "IRENE",
"middle_name": "PULIDO",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-01",
"last_updated": "2015-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14734",
"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 Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.