Optometric Center and Eyewear Galleria

Primary specialty

OptometristTaxonomy code 152W00000X

License

5287T Issued in CA

Legal business name

OPTOMETRIC CENTER AND EYEWEAR GALLERIA

Practice address

2551 San Ramon Valley Blvd.
Suite 101
San Ramon, CA 94583-1661

Phone

(925) 743-1222

Fax

(925) 743-1221

NPI assigned

Dec 11, 2014

Organization subpart

No

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

Authorized official

Name

Lyndsy Faulkner, CPOC

Title

Accounts Manager

Phone

(925) 743-1222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1972901684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 SAN RAMON VALLEY BLVD.",
            "address_2": "SUITE 101",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831661",
            "telephone_number": "925-743-1222",
            "fax_number": "925-743-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 SAN RAMON VALLEY BLVD.",
            "address_2": "SUITE 101",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831661",
            "telephone_number": "925-743-1222",
            "fax_number": "925-743-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC CENTER AND EYEWEAR GALLERIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-11",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "LYNDSY",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "925-743-1222",
        "authorized_official_credential": "CPOC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5287T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in San Ramon, CA
• Providers in San Ramon, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.