Mona Gill O D Corp

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MONA GILL O D CORP

Practice address

300 James Way Ste 210
Pismo Beach, CA 93449-2874

Phone

(805) 773-6000

Fax

(805) 773-2120

NPI assigned

Jun 29, 2021

Organization subpart

No

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

Authorized official

Name

Mona Kaur Gill, ODNPI 1477856003

Title

President

Phone

(661) 205-7287

Specialties & licenses 1

Addresses

Other names 1

• Advanced Eyecare Central Coast Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mona Kaur Gill, O.D.

  • Optometrist
  • Pismo Beach, CA
  • NPI 1477856003
  Medicare reassignment Care Compare group NPD Authorized official
• David Michael Malouf, OD

  • Optometrist
  • Arroyo Grande, CA
  • NPI 1093695827
  Medicare reassignment Care Compare group
• Scott Eric Schachter, O.D.

  • Optometrist
  • Pismo Beach, CA
  • NPI 1447230602
  NPD (past)
• Lauren Rebecca Tackett, O.D.

  • Optometrist
  • Atascadero, CA
  • NPI 1164618682
  NPD (past)

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1891365003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 JAMES WAY STE 210",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492874",
            "telephone_number": "805-773-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 JAMES WAY STE 210",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492874",
            "telephone_number": "805-773-6000",
            "fax_number": "805-773-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONA GILL O D CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "MONA",
        "authorized_official_middle_name": "KAUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-205-7287",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Eyecare Central Coast",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Eyecare Central Coast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy D Mierau, PA-C
• Vanessa Rose Miller
• Gerry Ann Mitchell
• Model Drug Inc
• Elissa Molfino, NP
• Laurie Katherine Moore, PA
• Sara A. Moorehouse, DO
• Judy Burke Morabito, C. PED.
• Moscardi Physical Therapy, Inc
• Louis Dominic Moscardi, P.T.

• Optometrist in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.