Gary L. Etting, O.D.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

OPT5519T Issued in CA

Practice address

6345 Balboa Blvd
BLDG III, Suite 250
Encino, CA 91316-1519

Phone

(818) 344-3937

Fax

(818) 344-1229

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Joseph and Nace Optometric CorporationGroup PAC ID 5597130922, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Joseph & Nace Optometric Corporation

  • Vision Therapy Optometrist
  • Encino, CA
  • NPI 1144994104
  Medicare reassignment Care Compare group NPD
• Gary L Etting OD an Optometric Corp

  • Optometrist
  • Encino, CA
  • NPI 1306950829

  Vision Therapy

  NPD Authorized official

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1912969619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6345 BALBOA BLVD",
            "address_2": "BLDG III, SUITE 250",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161519",
            "telephone_number": "818-344-3937",
            "fax_number": "818-344-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 BALBOA BLVD",
            "address_2": "BLDG III, SUITE 250",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161519",
            "telephone_number": "818-344-3937",
            "fax_number": "818-344-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTING",
        "first_name": "GARY",
        "middle_name": "L.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "OPT5519T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penuel Estabillo, PTA
• Nicholas Estacio, DPT
• Esteban Estrada
• Michael Estrada Jr.
• Maryam Etemadjam, PSY.D
• Eboni Denise Eubanks
• Evalina Josefsson Dental Group
• Rome Diostonne Evangelista, NP
• Michaele E Evans
• Ted D Evans, PH.D

• Vision Therapy Optometrist in Encino, CA
• Providers in Encino, CA by specialty
• Vision Therapy Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.