Provider Demographics
NPI:1760529275
Name:LANGSFORD, STEPHEN (OD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:LANGSFORD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:STEPHEN
Other - Middle Name:GREENE
Other - Last Name:LANGSFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:3085 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2999
Mailing Address - Country:US
Mailing Address - Phone:805-648-3085
Mailing Address - Fax:805-648-7027
Practice Address - Street 1:3085 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2999
Practice Address - Country:US
Practice Address - Phone:805-648-3085
Practice Address - Fax:805-648-7027
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10503T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0105030Medicaid
CAU58736Medicare UPIN
CAWOP10503AMedicare ID - Type Unspecified