Organization Active NPI

San Diego Vision Care, Inc.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1922155159
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10403T Issued in CA
Legal business name
SAN DIEGO VISION CARE, INC.
Practice address
3560 Fairmount Ave
San Diego, CA 92105-3420
Phone
(619) 508-5678
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Sheiva Pousti, O.D.NPI 1730240052
Title
Officer
Phone
(858) 504-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10403T CA Primary

Addresses

Primary practice location

3560 Fairmount Ave
San Diego, CA 92105-3420

Mailing address

PO Box 9545
San Diego, CA 92169-0545
Phone (858) 504-2020

Other identifiers 1

IdentifierTypeStateIssuer
SD0104030MedicaidCA

National Provider Directory

National Provider Directory

Locations

3560 Fairmount Ave
San Diego, CA 92105
Phone (619) 431-2020

Practitioners & affiliated clinicians

Practitioners 2

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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922155159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9545",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921690545",
            "telephone_number": "858-504-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921053420",
            "telephone_number": "619-508-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO VISION CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POUSTI",
        "authorized_official_first_name": "SHEIVA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "858-504-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10403T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0104030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • 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.