Pinhkeo Southaphanh O D Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

12359TLG Issued in CA

Legal business name

PINHKEO SOUTHAPHANH O D INC

Practice address

415 E Ocean Ave Ste B
Lompoc, CA 93436-6839

Phone

(805) 819-0742

Fax

(805) 741-7367

NPI assigned

Aug 17, 2016

Organization subpart

No

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

Authorized official

Name

Pinhkeo Southaphanh, O.D.NPI 1538139381

Title

President

Phone

(805) 819-0742

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Pinhkeo Southaphanh, O.D.

  • Optometrist
  • Lompoc, CA
  • NPI 1538139381
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1104371343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E OCEAN AVE STE B",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366839",
            "telephone_number": "805-819-0742",
            "fax_number": "805-741-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E OCEAN AVE STE B",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366839",
            "telephone_number": "805-819-0742",
            "fax_number": "805-741-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINHKEO SOUTHAPHANH O D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "SOUTHAPHANH",
        "authorized_official_first_name": "PINHKEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-819-0742",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12359TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538139381",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda Pierce
• William J Pierce, M.D.
• Stevie Dawn Pierson, M.A.
• Chirala Pillay-Jordan
• Rosa Marina Pinedo
• Philip S. Piro, PH.D.
• Megan Plumlee
• Veronica Porras
• Jennifer L Posey, MA BCBA
• Athena Audrey Powers, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.