NPIMap

Organization Active NPI

Precision Eye Care, a Medical Corp Clinic

  • Specialist
  • National City, CA
National Provider Identifier
1932111473
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G31591 Issued in CA
Legal business name
PRECISION EYE CARE, A MEDICAL CORP CLINIC
Practice address
655 Euclid Ave
Suite 302
National City, CA 91950-2957
Phone
(619) 472-1010
Fax
(619) 472-2092
NPI assigned
Aug 13, 2006
Last updated
Sep 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Gordon James Montgomery, M.D.
Title
Proprietor
Phone
(619) 472-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G31591 CA Primary

Addresses

Primary practice location

655 Euclid Ave
Suite 302
National City, CA 91950-2957

Mailing address

PO Box 81187
San Diego, CA 92138-1187
Phone (619) 472-1010

Other identifiers 3

IdentifierTypeStateIssuer
0648000001OtherCACIGNA-DURABLE EQUIP
GR0057790MedicaidCA
GSD0001350OtherCAMEDI-CAL OPTICAL

National Provider Directory

National Provider Directory

Locations

610 Euclid Ave
Ste 302
National City, CA 91950
Phone (619) 472-1010

655 Euclid Ave
Ste 302
National City, CA 91950
Phone (619) 472-1010

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1932111473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81187",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921381187",
            "telephone_number": "619-472-1010",
            "fax_number": "619-472-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 EUCLID AVE",
            "address_2": "SUITE 302",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502957",
            "telephone_number": "619-472-1010",
            "fax_number": "619-472-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION EYE CARE, A MEDICAL CORP CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "619-472-1010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G31591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA-DURABLE EQUIP",
            "identifier": "0648000001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0057790",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL OPTICAL",
            "identifier": "GSD0001350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.