Individual provider Active NPI

Enrique Metta Fallena, OPTICIAN

  • Optician
  • Chula Vista, CA
National Provider Identifier
1932738481
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
40581 Issued in CA
Practice address
651 Palomar St Ste A17
Chula Vista, CA 91911-2663
Phone
(619) 992-4291
Fax
(619) 422-2385
NPI assigned
Apr 6, 2020
Last updated
Apr 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 40581 CA Primary

Addresses

Primary practice location

651 Palomar St Ste A17
Chula Vista, CA 91911-2663

Mailing address

651 Palomar St Ste A17
Chula Vista, CA 91911-2663
Phone (619) 992-4291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40581CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Inc Optician CurrentSince Apr 19, 2020 Accepting new patients

Locations

651 Palomar St
Ste A17
Chula Vista, CA 91911
Phone (619) 422-2118

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1932738481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 PALOMAR ST STE A17",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112663",
            "telephone_number": "619-992-4291",
            "fax_number": "619-422-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 PALOMAR ST STE A17",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112663",
            "telephone_number": "619-992-4291",
            "fax_number": "619-422-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METTA FALLENA",
        "first_name": "ENRIQUE",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "40581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.