NUEVA VISION OPTICAL
NPI 1538403274
Preferred Provider Organization in Lynwood, CA

Active since November 19, 2012
3100 E IMPERIAL HWY, SUITE # 1109, LYNWOOD, CA 90262(310) 604-3851(310) 878-0301 Get Directions Write a Review

NPPES record last updated: November 19, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Preferred Provider Organization

About NUEVA VISION OPTICAL

This page provides the complete NPI Profile along with additional information for Nueva Vision Optical, a provider established in Lynwood, California operating as a Preferred Provider Organization. The healthcare provider is registered in the NPI registry with number 1538403274 assigned on November 2012. The practitioner's primary taxonomy code is 305R00000X with license number 2945 (CA). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Mr. Antonio Antonio Bustamante Sr. (Optician)

NPI
1538403274 Verify this NPI
Provider Name
NUEVA VISION OPTICAL
Entity Type
Organization
Location Address
3100 E IMPERIAL HWY SUITE # 1109 LYNWOOD, CA 90262
Location Phone
(310) 604-3851
Location Fax
(310) 878-0301
Mailing Address
3100 E IMPERIAL HWY SUITE # 1109 LYNWOOD, CA 90262
Mailing Phone
(310) 604-3851
Mailing Fax
(310) 878-0301
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-19-2012
Last Update Date
11-19-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Preferred Provider Organization

Taxonomy Code
305R00000X
Type
Managed Care Organizations
License No.
2945
License State
CA
Taxonomy Description
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. ANTONIO ANTONIO BUSTAMANTE SR.

Authorized Official Title
OPTICIAN
Authorized Official Phone
(310) 604-3851

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538403274, enumerated as an "organization" on November 19, 2012.

The provider is located at 3100 E IMPERIAL HWY SUITE # 1109 LYNWOOD, CA 90262 and the phone number is (310) 604-3851.

Preferred Provider Organization with taxonomy code 305R00000X.