Organization Active NPI

Uc2020 Optometry PC

  • Optometrist
  • Long Beach, CA
National Provider Identifier
1053552083
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12080T Issued in CA
Legal business name
UC2020 OPTOMETRY PC
Practice address
3000 E Anaheim St
Long Beach, CA 90804-3802
Phone
(562) 438-9438
Fax
(562) 438-9430
NPI assigned
Mar 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2009

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

Authorized official

Name
Phuong Hong Vu, O.D.NPI 1699795427
Title
President
Phone
(562) 438-9438

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 12080T CA Primary

Addresses

Primary practice location

3000 E Anaheim St
Long Beach, CA 90804-3802

Mailing address

3000 E Anaheim St
Long Beach, CA 90804-3802
Phone (562) 438-9438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090509000039 CA Part B Supplier - Clinic/Group Practice 8729136320 Receives reassigned benefits from 1 practitioner
Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory

Locations

3000 E Anaheim St
Long Beach, CA 90804
Phone (562) 438-9437

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1237593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242345600000",
    "number": "1053552083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043802",
            "telephone_number": "562-438-9438",
            "fax_number": "562-438-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043802",
            "telephone_number": "562-438-9438",
            "fax_number": "562-438-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UC2020 OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-21",
        "last_updated": "2009-05-15",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_middle_name": "HONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-438-9438",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12080T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.