Individual provider Active NPI

Molly Duong, OD

  • Optometrist
  • Chino, CA
National Provider Identifier
1023508363
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34200TLG Issued in CA
Practice address
5343 Riverside Dr
Chino, CA 91710-4252
Phone
(909) 285-9429
NPI assigned
May 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34200TLG CA Primary

Addresses

Primary practice location

5343 Riverside Dr
Chino, CA 91710-4252

Mailing address

421 S Astell Ave
West Covina, CA 91790-3116
Phone (626) 476-8805

Other practice location 1

2000 Market Place Dr
Monterey Park, CA 91755-7402
Phone (323) 726-7667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191125000767 CA Practitioner - Optometry 3072945450 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34200TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center Inc CurrentSince Jan 11, 2022 Accepting new patients
Unicare Community Health Center Inc Current Accepting new patients
Wayne H. Martin, M.D., Inc. CurrentSince Sep 23, 2019 Accepting new patients

Locations

5343 Riverside Dr
Chino, CA 91710
Phone (909) 364-0308

308 N La Cadena Dr
Colton, CA 92324
Phone (909) 321-4700

1111 Grand Ave
Ste A
Diamond Bar, CA 91765
Phone (909) 860-6768

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1023508363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 S ASTELL AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903116",
            "telephone_number": "626-476-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5343 RIVERSIDE DR",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104252",
            "telephone_number": "909-285-9429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Market Place Dr",
            "address_purpose": "LOCATION",
            "city": "Monterey Park",
            "state": "CA",
            "postal_code": "917557402",
            "country_code": "US",
            "telephone_number": "323-726-7667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUONG",
        "first_name": "MOLLY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34200TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.