Prudence Tam, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35217 Issued in CA

Practice address

8977 Foothill Blvd Ste C
Rancho Cucamonga, CA 91730-3498

Phone

(909) 987-4919

NPI assigned

Aug 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Quynh Tran Optometry, Inc

  • Optometrist
  • Chino, CA
  • NPI 1104340330
  NPD (past)

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1093497588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19071 BEAR VALLEY RD STE 3",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923082718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8977 FOOTHILL BLVD STE C",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303498",
            "telephone_number": "909-987-4919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S Park Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917661501",
            "country_code": "US",
            "telephone_number": "909-622-3531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAM",
        "first_name": "PRUDENCE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Melissa Tait, LCSW
• Ernest Takang, REGISTERED NURSE
• Talal Samaan MD PC
• Rishi Talwar, MD
• Isabella Tam
• Andrew J Tamanaha, PH.D.
• Alexa Tamayo
• Christine Tambunan
• Florence Tamayo Tampoya, M.D.
• Madeline Tampubolon

• Optometrist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.