GENNADY GARY BDIL (NPI# 1023158060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023158060 |
| Entity Type | Individual |
| Full Name | GENNADY GARY BDIL |
| Practice Address |
453 N Fairfax Ave Los Angeles CA 90036-1716 |
| Practice Telephone | 3236515976 |
| Practice Fax Number | 3236515367 |
| Mailing Telephone | 3236515976 |
| Mailing Fax Number | 3236515367 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
D 6860 | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DX006860F | 05 |
| Street Address |
453 N FAIRFAX AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90036-1716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140198 | Stephanie N Carter | Dietitian, Registered | 460 Burnside Ave, Apt 8k, Los Angeles, CA 90036 | 2020-06-26 |
| 1609492107 | Katherine Niemela | Registered Nurse | 5619 W 4th St, Suite 5, Los Angeles, CA 90036 | 2020-06-19 |
| 1508384330 | Matthew Milstein | Psychologist | 5675 West Olympic Blvd., Los Angeles, CA 90036 | 2017-08-31 |
| 1912423963 | John Allen Ostlund | Counselor | 5675 W. Olympic Blvd, Los Angeles, CA 90036 | 2017-08-21 |
| 1306376629 | Scott William Wilson | Case Manager/Care Coordinator | 1891 N. Gaffey Street Suite 219 & 221, San Pedro, CA 90036 | 2017-06-19 |
| 1205382298 | Janice Payson | Marriage & Family Therapist | 801 South Spaulding Avenue, Suite A, Los Angeles, CA 90036 | 2016-08-30 |
| 1134577281 | Parul A Desai | Registered Nurse | 5800 Wilshire Blvd, Los Angeles, CA 90036 | 2016-05-31 |
| 1477914604 | Sarah Frank Jarvis | Marriage & Family Therapist | 7421 Beverly Blvd Ste 2, Los Angeles, CA 90036 | 2016-03-16 |
| 1558747162 | Paul Oberon, Psy.d, Inc. | Community/Behavioral Health | 7421 Beverly Blvd., #10, Los Angeles, CA 90036 | 2015-08-05 |
| 1235543117 | Benjamin Maixner | Behavioral Analyst | 441 1/2 N Curson Ave, Los Angeles, CA 90036 | 2014-06-18 |
| Find all providers in zip 90036 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1134685613 | National Vision Inc | Technician/Technologist | 5818 Santa Monica Boulevard, Los Angeles, CA 90038 | 2019-02-20 |
| 1922514280 | Cvs Aoc Corporation | Technician/Technologist | 5822 S Vermont Ave # 8892, Los Angeles, CA 90044-3712 | 2017-12-22 |
| 1689183527 | National Vision, Inc. | Technician/Technologist | 1837 S La Cienega Blvd, Los Angeles, CA 90035-4654 | 2017-09-22 |
| 1952820458 | National Vision, Inc. | Technician/Technologist | 1713 S Western Ave, Los Angeles, CA 90006-5803 | 2017-09-15 |
| 1013452358 | Tai Ho Kim | Technician/Technologist | 3500 W 6th St Ste 122, Los Angeles, CA 90020-5801 | 2016-12-22 |
| 1518359090 | Poong In | Technician/Technologist | 2837 W Olympic Blvd # A, Los Angeles, CA 90006-2611 | 2015-02-20 |
| 1801020482 | Brian Isaiah Igbinigie | Technician/Technologist | 10885 W Pico Blvd, Los Angeles, CA 90064-2114 | 2009-05-11 |
| 1154576155 | Clearview Vision | Technician/Technologist | 5419 W Sunset Blvd, Los Angeles, CA 90027-5691 | 2008-11-19 |
| 1063662948 | Keum B Lee | Technician/Technologist | 2835 W Pico Blvd, Los Angeles, CA 90006-3910 | 2008-09-26 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90036 |
Please comment or provide details below to improve the information on GENNADY GARY BDIL.
| 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.