Organization Active NPI

Viktoria Goldenberg,OD Optometry Corporation

  • Clinic/Center
  • West Hills, CA
National Provider Identifier
1992984991
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
12754T Issued in CA
Legal business name
VIKTORIA GOLDENBERG,OD OPTOMETRY CORPORATION
Practice address
6433 Fallbrook Ave
West Hills, CA 91307-3543
Phone
(818) 703-1410
Fax
(818) 703-9079
NPI assigned
Oct 26, 2007
Last updated
Sep 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Dr. Viktoriya Goldenberg, ODNPI 1538290929
Title
Ceo
Phone
(323) 804-4794

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
Clinic/Center 261Q00000X 12754T CA Primary

Addresses

Primary practice location

6433 Fallbrook Ave
West Hills, CA 91307-3543

Mailing address

8554 De Soto Ave Unit 44
Canoga Park, CA 91304-2993
Phone (323) 804-4794

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121112000172 CA Part B Supplier - Clinic/Group Practice 1658458179 Receives reassigned benefits from 1 practitioner
Practice locations: West Hills, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1992984991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8554 DE SOTO AVE UNIT 44",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913042993",
            "telephone_number": "323-804-4794",
            "fax_number": "818-703-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6433 FALLBROOK AVE",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913073543",
            "telephone_number": "818-703-1410",
            "fax_number": "818-703-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIKTORIA GOLDENBERG,OD OPTOMETRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "GOLDENBERG",
        "authorized_official_first_name": "VIKTORIYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-804-4794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "12754T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.