NPI Code Detail JSON Logo

1114353687 NPI number — VAN LE SIM O.D.

NPI Number: 1114353687
Health Care Provider/Practitioner: VAN LE SIM O.D.

Information about “1114353687” NPI (VAN LE SIM O.D.) exists in 1114353687 in HTML format HTML  |  1114353687 in plain Text format TXT  |  1114353687 in PDF (Portable Document Format) PDF  |  1114353687 in an XML format XML  formats.

NPI Number : 1114353687 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114353687",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SIM",
    "FirstName": "VAN",
    "MiddleName": "LE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "O.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "200 E CYPRESS AVE",
    "SecondLineMailingAddress": "LENSCRAFTERS AT MACY'S",
    "MailingAddressCityName": "BURBANK",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91502-1149",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "818-557-1659",
    "MailingAddressFaxNumber": "818-557-1697",
    "FirstLinePracticeLocationAddress": "200 E CYPRESS AVE",
    "SecondLinePracticeLocationAddress": "LENSCRAFTERS AT MACY'S",
    "PracticeLocationAddressCityName": "BURBANK",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91502-1149",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "818-557-0016",
    "PracticeLocationAddressFaxNumber": "818-557-1697",
    "EnumerationDate": "09/17/2013",
    "LastUpdateDate": "11/27/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "OPT14840-TLG",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.