NPIMap

Organization Active NPI

William S Brawders OD a PC

  • Optometrist
  • Palmdale, CA
National Provider Identifier
1972817997
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9210T Issued in CA
Legal business name
WILLIAM S BRAWDERS OD A PC
Practice address
40033 10TH St W
Unit a
Palmdale, CA 93551-3016
Phone
(661) 265-7515
Fax
(661) 265-0883
NPI assigned
Aug 2, 2010
Last updated
Jul 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Dr. William Steven Brawders, ODNPI 1093888711
Title
President
Phone
(661) 265-7515

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 9210T CA Primary

Addresses

Primary practice location

40033 10TH St W
Unit a
Palmdale, CA 93551-3016

Mailing address

40033 10TH St W Ste a
Palmdale, CA 93551-3016
Phone (661) 265-7515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110124000304 CA Part B Supplier - Clinic/Group Practice 1254510258 Receives reassigned benefits from 5 practitioners
Practice locations: Palmdale, CA

National Provider Directory

National Provider Directory

Locations

1233 W Rancho Vista Blvd
Ste 405
Palmdale, CA 93551
Phone (661) 265-7515

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1972817997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40033 10TH ST W STE A",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513016",
            "telephone_number": "661-265-7515",
            "fax_number": "661-265-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40033 10TH ST W",
            "address_2": "UNIT A",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513016",
            "telephone_number": "661-265-7515",
            "fax_number": "661-265-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM S BRAWDERS OD A PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "BRAWDERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-265-7515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9210T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.