Unknown Individual – Pediatric Optometrist, NPI 1043312200

Unknown Individual is a healthcare provider. based in Poway, California. specializing in Pediatric Optometrist. They hold a License No. 5407T (CA). The NPI Number for Unknown Individual is 1043312200

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043312200
Phone
(858) 748-6210
Address
PO BOX 766
Deactivation Date
17 July 2025

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
8587486210
Graduation Year
1972 (54 years ago)
PAC ID
0042363905
Professional Enrollment ID
I20090725000049
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO BOX 766

    POWAY, CA 920740766

    Phone: (858) 748-6210

    Fax: (858) 748-6224

    Type: Mailing

  • Poway Road, Poway, San Diego County, California, United States

    SUITE 209

    POWAY, CA 920644529

    Phone: (858) 748-6210

    Fax: (858) 748-6224

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $252.

Total Amount is formed as General ($252) + Research ($0) + Ownership ($0) = $252.

Last reported payment date: 2024-08-13 • Largest payer in this snapshot: Alcon Vision LLC ($148).

Total Amount

$252

General + Research + Ownership

Payments

2

Total payment records

General Amount

$252

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Alcon Vision LLC$148
RxSight Inc$104
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92074)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1043312200; it appears in the national provider directory.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Pediatric Optometrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Poway, California for Unknown Individual; expand the address list for detail.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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