NPIMap

Organization Active NPI

Tanya N Gill Optometric, Inc.

  • Optometrist
  • Oakland, CA
National Provider Identifier
1891982948
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11136T Issued in CA
Legal business name
TANYA N GILL OPTOMETRIC, INC.
Practice address
1960 Broadway
Oakland, CA 94612-2206
Phone
(510) 893-5566
Fax
(510) 893-3921
NPI assigned
Oct 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Tanya Natashia Gill, O.D.
Title
President
Phone
(510) 893-5566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 11136T CA Primary

Addresses

Primary practice location

1960 Broadway
Oakland, CA 94612-2206

Mailing address

1960 Broadway
Oakland, CA 94612-2206
Phone (510) 893-5566

Other identifiers 1

IdentifierTypeStateIssuer
11136TOtherCAOPTOMETRY LICENSE

Other names 1

  • Oakland Vision Center Doing business as

National Provider Directory

National Provider Directory

Locations

1960 Broadway
Oakland, CA 94612
Phone (510) 893-5566

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1891982948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 BROADWAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122206",
            "telephone_number": "510-893-5566",
            "fax_number": "510-893-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 BROADWAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122206",
            "telephone_number": "510-893-5566",
            "fax_number": "510-893-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANYA N GILL OPTOMETRIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "NATASHIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-893-5566",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11136T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE",
            "identifier": "11136T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakland Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.

Verify at the official NPI Registry.