Dr. Mark L. Jaffe

Primary specialty

OptometristTaxonomy code 152W00000X

License

114 Issued in AZ

Legal business name

DR. MARK L. JAFFE

Practice address

6666 W Peoria Ave
Suite 109
Glendale, AZ 85302-7014

Phone

(623) 979-8876

Fax

(623) 979-2811

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Lawrence Jaffe, O.D.

Title

Owner

Phone

(623) 979-8876

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Alice Kwok, O.D.

  • Optometrist
  • Peoria, AZ
  • NPI 1417014119
  NPD (past)
• Thuy Ngoc Yath, OD

  • Optometrist
  • Anthem, AZ
  • NPI 1114278637
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902958135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6666 W PEORIA AVE",
            "address_2": "SUITE 109",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853027014",
            "telephone_number": "623-979-8876",
            "fax_number": "623-979-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6666 W PEORIA AVE",
            "address_2": "SUITE 109",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853027014",
            "telephone_number": "623-979-8876",
            "fax_number": "623-979-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARK L. JAFFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-979-8876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OPTOMETRIC LICENSE",
            "identifier": "114",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr Bereket a Guangul
• Dr Harshad Patel MD PC
• Dr. Farzin Allameh DDS PC
• Dr. Greg Ceyhan DDS, PLLC
• Dr. John Schrolucke, Optometrist
• Dr. Ryan Ambrose, PLLC
• Patricia Ann Drace, M.D.
• Mason Drajer
• Rebecca Drake
• Remi Cyril Drake

• Optometrist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Optometrist in Arizona

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.