NPIMap

Organization Active NPI

Sacks Optical Boutique, LLC

  • Eyewear Supplier
  • Los Angeles, CA
National Provider Identifier
1942537089
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
G64460 Issued in CA
Legal business name
SACKS OPTICAL BOUTIQUE, LLC
Practice address
1125 S Beverly Dr
710
Los Angeles, CA 90035-1148
Phone
(310) 275-1676
NPI assigned
Nov 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Authorized official

Name
Dr. Robert David Sacks, M.D.NPI 1568518637
Title
President
Phone
(310) 275-1676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X G64460 CA Primary

Addresses

Primary practice location

1125 S Beverly Dr
710
Los Angeles, CA 90035-1148

Mailing address

1125 S Beverly Dr
710
Los Angeles, CA 90035-1148
Phone (310) 275-1676

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1942537089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR",
            "address_2": "710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351148",
            "telephone_number": "310-275-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR",
            "address_2": "710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351148",
            "telephone_number": "310-275-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACKS OPTICAL BOUTIQUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "SACKS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-275-1676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "G64460",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 22, 2010; 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.