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1871546341 NPI number — AGOURA-WEST VALLEY OPTOMETRIC CENTER

NPI Number: 1871546341
Health Care Provider/Practitioner: AGOURA-WEST VALLEY OPTOMETRIC CENTER

Information about “1871546341” NPI (AGOURA-WEST VALLEY OPTOMETRIC CENTER) exists in 1871546341 in HTML format HTML  |  1871546341 in plain Text format TXT  |  1871546341 in PDF (Portable Document Format) PDF  |  1871546341 in an XML format XML  formats.

NPI Number : 1871546341 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871546341",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "AGOURA-WEST VALLEY OPTOMETRIC CENTER",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6800 OWENSMOUTH AVE",
    "SecondLineMailingAddress": "#400",
    "MailingAddressCityName": "CANOGA PARK",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91303-3159",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "818-340-5796",
    "MailingAddressFaxNumber": "818-340-4030",
    "FirstLinePracticeLocationAddress": "6800 OWENSMOUTH AVE",
    "SecondLinePracticeLocationAddress": "#400",
    "PracticeLocationAddressCityName": "CANOGA PARK",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91303-3159",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "818-340-5796",
    "PracticeLocationAddressFaxNumber": "818-340-4030",
    "EnumerationDate": "05/18/2006",
    "LastUpdateDate": "06/16/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LAI",
    "AuthorizedOfficialFirstName": "DANITA",
    "AuthorizedOfficialMiddleName": "SAM",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "O.D.",
    "AuthorizedOfficialTelephoneNumber": "818-340-5796",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": "8019TPL",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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