Provider Demographics
NPI:1013803535
Name:COMPTON, CASSIDY ROSE (OD)
Entity type:Individual
Prefix:DR
First Name:CASSIDY
Middle Name:ROSE
Last Name:COMPTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:COMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:5226 MARINA PACIFICA DR S
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3890
Mailing Address - Country:US
Mailing Address - Phone:714-624-2672
Mailing Address - Fax:
Practice Address - Street 1:1509 HAWTHORNE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3957
Practice Address - Country:US
Practice Address - Phone:714-624-2672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35991152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist