IMPERIAL BEACH OPTOMETRIC CORPORATION (NPI# 1790249563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790249563 |
| Entity Type | Organization |
| Organization Name | IMPERIAL BEACH OPTOMETRIC CORPORATION |
| Practice Address |
1555 Palm Ave Ste A2 San Diego CA 92154-1012 |
| Practice Telephone | 6192972020 |
| Practice Fax Number | 8882105799 |
| Mailing Telephone | 6192972020 |
| Mailing Fax Number | 8882105799 |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-25 |
| Authorized Official Name | MAY TAM (IBOC VICE PRESIDENT) |
| Authorized Official Telephone | 6192972020 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Optom-Eyes Vision Care | Doing Business As Name - Organization |
| Street Address |
1555 PALM AVE STE A2 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92154-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952922783 | Rosalie Ramos Gayares | Licensed Vocational Nurse | Del Sur Crisis Center, San Diego, CA 92154 | 2020-05-04 |
| 1720625791 | Michelle Lynn Mason | Counselor | 892 27th Street, San Diego, CA 92154 | 2019-12-09 |
| 1538604020 | Victor Luis Assid | Counselor | 3069 Camino Aleta, San Diego, CA 92154 | 2016-12-20 |
| 1710346275 | Abba Transportation Services LLC | Non-emergency Medical Transport (VAN) | 5640 Surfrider Way #255, San Diego, CA 92154 | 2016-02-12 |
| 1851788962 | Danielle D. Weisman | Psychologist | 9335 Airway Rd Ste 202, San Diego, CA 92154 | 2015-04-16 |
| 1215321955 | Carolina Gonzalez-garcia | Marriage & Family Therapist | 3085 Beyer Blvd Ste A103, San Diego, CA 92154 | 2015-03-19 |
| 1285042945 | Maricela Ochoa | Pharmacist | 710 Dennery Road, San Diego, CA 92154 | 2014-07-25 |
| 1376975300 | Shatori R Dearman | Social Worker | 5143 Bay Crest Ln, San Diego, CA 92154 | 2013-08-01 |
| 1912257940 | Bj's Trading LLC | Durable Medical Equipment & Medical Supplies | 9668 Heinrich Hertz Drive Suite G, San Diego, CA 92154 | 2012-09-18 |
| 1881997625 | Tywila Reeves Bivens | Nurse's Aide | 976 Picador Blvd, San Diego, CA 92154 | 2010-12-17 |
| Find all providers in zip 92154 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720699432 | Emily Thai | Optometrist | 10994 W Ocean Air Dr Apt 286, San Diego, CA 92130-4635 | 2020-08-14 |
| 1841800018 | Luminoptix Optometry | Optometrist | 655 Saturn Blvd Ste H, San Diego, CA 92154-4734 | 2020-08-03 |
| 1427673680 | Courtney Lynn Cape | Optometrist | 4353 La Jolla Village Dr Ste H-20, San Diego, CA 92122-1242 | 2020-06-13 |
| 1073137691 | Charles Tu | Optometrist | 2150 Pacific Beach Dr Apt 234, San Diego, CA 92109-5639 | 2020-05-29 |
| 1538796578 | Wilson Phu | Optometrist | 3345 Rosecrans St Ste B, San Diego, CA 92110-4225 | 2020-03-26 |
| 1346874971 | Florena Culas | Optometrist | 7477 Goode St, San Diego, CA 92139-3931 | 2020-02-22 |
| 1235786633 | Courtney Hongo | Optometrist | San Diego Va 3350 La Jolla Village Dr #1125, San Diego, CA 92161-0001 | 2019-08-20 |
| 1467012740 | Luis G. Perez-rivera Od Optometric Corporation | Optometrist | 11134 Rancho Carmel Dr Ste 102, San Diego, CA 92128-4671 | 2019-06-18 |
| 1063972438 | Fabian Luna Od, Inc | Optometrist | 9855 Erma Rd Ste 130, San Diego, CA 92131-1092 | 2019-03-22 |
| 1861966293 | Kathrine Vidaurri | Optometrist | 3588 Torrey View Ct, San Diego, CA 92130-2635 | 2019-01-18 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.