Organization Active NPI

Supervista North America

  • Eyewear Supplier
  • Laguna Hills, CA
National Provider Identifier
1902489628
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SUPERVISTA NORTH AMERICA
Practice address
24012 Avenida de la Carlota ,Ste G
Laguna Hills, CA 92653-9265
Phone
(949) 237-7670
NPI assigned
Apr 30, 2021
Organization subpart
Yes
Parent organization
SUPERVISTA NORTH AMERICAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Kourosh Zakeri
Title
Coo North America
Phone
(949) 441-4021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

24012 Avenida de la Carlota ,Ste G
Laguna Hills, CA 92653-9265

Mailing address

16 Technology Dr Ste 130
Irvine, CA 92618-2325
Phone (949) 441-4021

Other names 1

  • brillen.com Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Supervista North America23 organizations share this tax ID, including this one
Part of
Supervista North America

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

24012 Avenida de la Carlota
Ste G
Laguna Hills, CA 92653
Phone (949) 237-7670

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1902489628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TECHNOLOGY DR STE 130",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182325",
            "telephone_number": "949-441-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 AVENIDA DE LA CARLOTA ,STE G",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926539265",
            "telephone_number": "949-237-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERVISTA NORTH AMERICA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUPERVISTA NORTH AMERICA",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "ZAKERI",
        "authorized_official_first_name": "KOUROSH",
        "authorized_official_title_or_position": "COO NORTH AMERICA",
        "authorized_official_telephone_number": "949-441-4021"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "brillen.com",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.