Individual provider Active NPI

Robert Rothbard, O.D.

  • Optometrist
  • Alta Loma, CA
National Provider Identifier
1932286689
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CA7326T Issued in CA
Practice address
10598 Baseline Rd
Ste. B
Alta Loma, CA 91701-6330
Phone
(909) 980-3535
Fax
(909) 980-2684
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CA7326T CA Primary

Addresses

Primary practice location

10598 Baseline Rd
Ste. B
Alta Loma, CA 91701-6330

Mailing address

7211 Haven Ave
Ste a
Rancho Cucamonga, CA 91701-6064
Phone (909) 980-3535

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140312000268 CA Practitioner - Optometry 5193955276 Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7326CAMDProfessional Counselor
CA7326TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1932286689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 HAVEN AVE",
            "address_2": "STE A",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917016064",
            "telephone_number": "909-980-3535",
            "fax_number": "909-980-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10598 BASELINE RD",
            "address_2": "STE. B",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917016330",
            "telephone_number": "909-980-3535",
            "fax_number": "909-980-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBARD",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "CA7326T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alta Loma, CA

Sources for this page

Verify at the official NPI Registry.