Active NPI
Adrina Alahdadi-Ovanessian, O.D.
- Optometrist
- Los Angeles, CA
National Provider Identifier
1942333596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 12108 TPA
- Practice address
- 4170 Verdugo Rd
Los Angeles, CA 90065-3821 - Phone
- (323) 255-8093
- Fax
- (323) 255-8095
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT 12108 TPA | CA | Primary |
Addresses
Primary practice location
4170 Verdugo Rd
Los Angeles, CA 90065-3821
Mailing address
4170 Verdugo Rd
Los Angeles, CA 90065-3821
Phone (323) 255-8093
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211484 | Other | CA | EYE MED VISION |
| 13192 | Other | CA | MEDICAL EYE SERVICES |
| 470848075 | Other | CA | VISION SERVICE PLAN |
| SD0121080 | Medicaid | CA | |
| 43936 | Other | CA | SPECTERA VISION |
| 470848075 | Other | CA | BLUE CROSS OF CALIFORNIA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12108 | CA | MD | Social Worker |
| OPT 12108 TPA | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324598400000",
"number": "1942333596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4170 VERDUGO RD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900653821",
"telephone_number": "323-255-8093",
"fax_number": "323-255-8095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4170 VERDUGO RD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900653821",
"telephone_number": "323-255-8093",
"fax_number": "323-255-8095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALAHDADI-OVANESSIAN",
"first_name": "ADRINA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2011-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 12108 TPA",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYE MED VISION",
"identifier": "211484",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EYE SERVICES",
"identifier": "13192",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION SERVICE PLAN",
"identifier": "470848075",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0121080",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA VISION",
"identifier": "43936",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF CALIFORNIA",
"identifier": "470848075",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.