NPIMap

Organization Active NPI

Debra G Tennen, MD, a Professional Medical Corporation

  • Ophthalmology Physician
  • Agoura Hills, CA
National Provider Identifier
1942355151
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G72013 Issued in CA
Legal business name
DEBRA G TENNEN, MD, A PROFESSIONAL MEDICAL CORPORATION
Practice address
29525 Canwood St Ste 210
Agoura Hills, CA 91301-4231
Phone
(818) 707-4277
Fax
(818) 707-4291
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Dr. Debra G Tennen, M.D.
Title
Owner
Phone
(818) 707-4277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G72013 CA Primary

Addresses

Primary practice location

29525 Canwood St Ste 210
Agoura Hills, CA 91301-4231

Mailing address

29525 Canwood St Ste 210
Agoura Hills, CA 91301-4231
Phone (818) 707-4277

Other names 1

  • Agoura Hills Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

29525 Canwood St
Agoura Hills, CA 91301
Phone (818) 706-8099

29525 Canwood St
Ste 210
Agoura Hills, CA 91301
Phone (818) 707-4277

Practitioners & affiliated clinicians

Practitioners 7

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1942355151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST STE 210",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014231",
            "telephone_number": "818-707-4277",
            "fax_number": "818-707-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST STE 210",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014231",
            "telephone_number": "818-707-4277",
            "fax_number": "818-707-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA G TENNEN, MD, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "TENNEN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-707-4277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G72013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agoura Hills Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Agoura Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.