GARY L ETTING OD AN OPTOMETRIC CORP (NPI# 1306950829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306950829 |
| Entity Type | Organization |
| Organization Name | GARY L ETTING OD AN OPTOMETRIC CORP |
| Practice Address |
6345 Balboa Blvd Bldg 3 Suite 250 Encino CA 91316 |
| Practice Telephone | 8183443937 |
| Practice Fax Number | 8183441229 |
| Mailing Telephone | 8183443937 |
| Mailing Fax Number | 8183441229 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2014-12-02 |
| Authorized Official Name | DR. GARY L ETTING (OWNER) |
| Authorized Official Telephone | 8183443937 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
OPT 5519 T | CA | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | OPT 5519 T | CA | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | OPT5519 | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | OTHER MEDICARE PTAN | WOP5519A | 01 |
| Street Address |
6345 BALBOA BLVD BLDG 3 SUITE 250 |
| City | ENCINO |
| State | CA |
| Zip Code | 91316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720049034 | Mark C. Park | Optometrist | 6345 Balboa Blvd, Building 3, Suite 250, Encino, CA 91316-1519 | 2006-03-28 |
| 1417319559 | Mor Shapiro | Student in an Organized Health Care Education/Training Program | 6345 Balboa Blvd, Building 4, Ste 375, Encino, CA 91316 | 2016-03-28 |
| 1073974481 | Tammy Van Fleet | Behavioral Analyst | 6345 Balboa Blvd, Suite 163, Encino, CA 91316-1519 | 2016-03-11 |
| 1942674049 | Adelpha Psychiatric Group, Inc. | Psychiatry & Neurology | 6345 Balboa Blvd, Suite 199, Encino, CA 91316-1519 | 2015-11-30 |
| 1952717480 | A-1 Hospice Care Center 4 U, Inc. | Hospice Care, Community Based | 6345 Balboa Blvd, Suite #168, Encino, CA 91316 | 2014-07-03 |
| 1114331097 | Rebecca Friedman Novick | Nurse Practitioner | 6345 Balboa Blvd, Suite 213, Encino, CA 91316-1519 | 2014-06-18 |
| 1417382680 | Jha Geriatric Services, Inc | Home Health | 6345 Balboa Blvd, Suite 213, Encino, CA 91316-1517 | 2013-09-06 |
| 1679917660 | Elizabeth S Yung | Nurse Practitioner | 6345 Balboa Blvd, Suite 213, Encino, CA 91316-1519 | 2013-04-22 |
| 1265778914 | Nancy M. Terrebonne | Occupational Therapist | 6345 Balboa Blvd, Suite 120, Encino, CA 91316-1519 | 2012-12-28 |
| 1508114125 | Narges Menalagha | Dentist | 6345 Balboa Blvd, #314, Building #1, Encino, CA 91316-1519 | 2012-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548883341 | Kerry Ann Mclean | Marriage & Family Therapist | 1777 Ventura Blvd Unit 103, Encino, CA 91316 | 2020-05-27 |
| 1336793124 | Achieve Speech Associates, Inc. | Clinic/Center | 17605 Ventura Boulevard, #302, Encino, CA 91316 | 2019-07-30 |
| 1053978312 | Somnia Sleep Science & Treatment Center | Clinic/Center | 5435 Balboa Blvd Suite 100, Encino, CA 91316 | 2019-05-22 |
| 1437634466 | New Spirit Recovery, LLC | Substance Abuse Rehabilitation Facility | 17856 Cathedral Pl., Encino, CA 91316 | 2018-09-25 |
| 1649762014 | Hashemi Ophthalmology, PC | Ophthalmology | 5353 Balboa Blvd Ste 110, Encino, CA 91316 | 2018-06-01 |
| 1932614310 | Hannah Esther Weinsrein | Marriage & Family Therapist | 17337 Ventura Blvd., Sutie #317, Encino, CA 91316 | 2017-12-07 |
| 1881118560 | Paula Miley | Marriage & Family Therapist | 5535 Balboa Blvd #202, Encino, CA 91316 | 2017-08-03 |
| 1477088193 | Rachela Conti | Psychologist | 5400 Balboa Blvd. #311, Encino, CA 91316 | 2017-05-01 |
| 1962857235 | Jessica Shlager | Occupational Therapist | 6345 Balboa Boulevard Suite 120, Encino, CA 91316 | 2016-04-25 |
| 1720432800 | Canyon West Los Angeles LLC | Clinic/Center | 17167 W. Ventura Boulevard, Encino, CA 91316 | 2016-04-14 |
| Find all providers in zip 91316 | ||||
| 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 |
|---|---|---|---|---|
| 1154970614 | Aida Amin | Optometrist | 5363 Balboa Blvd Ste 141, Encino, CA 91316-2821 | 2019-09-08 |
| 1477083178 | Stephanie Marten-ellis | Optometrist | 16255 Ventura Blvd Ste 705, Encino, CA 91436-2311 | 2017-06-14 |
| 1346775319 | Flordeliz Grace Gonzales | Optometrist | 5460 White Oak Ave Unit C339, Encino, CA 91316-4561 | 2017-04-26 |
| 1821533647 | Christine J Cheng, Od, A Professional Corporation | Optometrist | 16055 Ventura Blvd Ste 690, Encino, CA 91436-2631 | 2017-01-03 |
| 1154723997 | Sarah Reyes Haakonsen | Optometrist | 16311 Ventura Blvd Ste 750, Encino, CA 91436-4325 | 2014-09-24 |
| 1801205638 | Sandy Tran | Optometrist | 6345 Balboa Blvd Ste 250, Encino, CA 91316-5236 | 2014-08-06 |
| 1043449655 | Mary Demirjian | Optometrist | 16055 Ventura Blvd Ste 630, Encino, CA 91436-2614 | 2009-07-06 |
| 1013193127 | Encino Optometric Center Corp. | Optometrist | 16550 Ventura Blvd Ste 312, Encino, CA 91436-2034 | 2008-01-18 |
| 1457471393 | Sol Regwan | Optometrist | 16430 Ventura Blvd Ste 106, Encino, CA 91436-2135 | 2007-03-31 |
| 1619056835 | Jeffrey Prentice Michelman | Optometrist | 17283 Ventura Blvd, Encino, CA 91316-4007 | 2006-11-06 |
| Find all providers in ENCINO | ||||
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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.