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MARSHALL B. KETCHUM UNIVERSITY/UNIVERSITY EYE CENTER AT LOS ANGELES NPI 1558467225


NPI Information

NPI: 1558467225
Provider Name: MARSHALL B. KETCHUM UNIVERSITY/UNIVERSITY EYE CENTER AT LOS ANGELES

Doing Business As: OPTOMETRIC CENTER OF LOS ANGELES

Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
3916 S. BROADWAY
LOS ANGELES, CA
ZIP 90037
Phone: (323) 234-9137
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MARSHALL B. KETCHUM UNIVERSITY/UNIVERSITY EYE CENTER AT LOS ANGELES is an optometrist in Los Angeles, CA. The provider is 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. MARSHALL B. KETCHUM UNIVERSITY/UNIVERSITY EYE CENTER AT LOS ANGELES NPI is 1558467225. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Optometric Center Of Los Angeles.

The provider's business location address is:

3916 S. BROADWAY
LOS ANGELES, CA
ZIP 90037
Phone: (323) 234-9137
Fax: (323) 235-6203

The provider's authorized official is Mark E. Nakeno .
The authorized official title is Clinic Director and has the following contact phone number (323) 234-9137.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 10/8/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist5827 TPLCALIFORNIANo
2152W00000XOptometristCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZT 11740FMEDICAIDCALIFORNIA
244593MEDICARE PINCALIFORNIA
3WY1110MEDICARE UPINCALIFORNIA
4ZZT11740FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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