Mai Nguyen, O.D., Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MAI NGUYEN, O.D., OPTOMETRIC CORPORATION

Practice address

15070 Summit Ave Ste 400
Fontana, CA 92336-5496

Phone

(909) 538-9246

NPI assigned

Nov 5, 2024

Organization subpart

No

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

Authorized official

Name

Mai Nguyen, ODNPI 1730721739

Title

Optometrist, Owner

Phone

(909) 538-9246

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Mai Nguyen

  • Optometrist
  • Riverside, CA
  • NPI 1730721739
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1093538324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 SOLAIRE WAY",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917107226",
            "telephone_number": "909-538-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15070 SUMMIT AVE STE 400",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365496",
            "telephone_number": "909-538-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAI NGUYEN, O.D., OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MAI",
        "authorized_official_title_or_position": "OPTOMETRIST, OWNER",
        "authorized_official_telephone_number": "909-538-9246",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Mah
• Mahin N Jahromi Dental Group Inc
• Aster Mahmood, MD
• Wajeha Hamdi Mahmoud
• Barbara Ann Mahoney, RNP
• Aimee Hernandez Maiava, PHARMD
• Rahul Maini, MD
• Kathryn Maiorano, PA-C
• Carly Denise Maitlen, RD
• Jason Mak, MD

• Optometrist in Fontana, CA
• Providers in Fontana, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.