Eden Plaza Optometry

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

OPT 12630T Issued in CA

Legal business name

EDEN PLAZA OPTOMETRY

Practice address

3555 Rosecrans St Ste 102
San Diego, CA 92110-3232

Phone

(619) 758-0639

Fax

(619) 758-0700

NPI assigned

May 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Hoa Phuong Nguyen, O.D

Title

President

Phone

(619) 758-0639

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1211587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211587200000",
    "number": "1154589331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 ROSECRANS ST STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103232",
            "telephone_number": "619-758-0639",
            "fax_number": "619-758-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 ROSECRANS ST STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103232",
            "telephone_number": "619-758-0639",
            "fax_number": "619-758-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN PLAZA OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-24",
        "last_updated": "2008-05-24",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "HOA PHUONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-758-0639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "OPT 12630T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid Kruse Edelman, DPM
• Joni Edelman, LMFT
• Steven V Edelman, M.D.
• Ronald Jay Edelson, MD
• Aaron Geoffrey Edelstein, M.D.
• Bruce L. Edens, MD
• Leanna Ederer
• Guadalupe Managuit Edgar
• Timothy Ryan Edgar, IDC
• Edge Home Health Inc.

• Low Vision Rehabilitation Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Low Vision Rehabilitation Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.