Active NPI
Michelle Nguyen
- Optometrist
- Fremont, CA
National Provider Identifier
1164942017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT33753-TLG
- Practice address
- 39201 Fremont Blvd
Fremont, CA 94538-1301 - Phone
- (510) 936-8048
- NPI assigned
- Jun 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | OPT33753-TLG | CA | Primary |
Addresses
Primary practice location
39201 Fremont Blvd
Fremont, CA 94538-1301
Mailing address
3068 Vesuvius LN
San Jose, CA 95132-2353
Other practice location 1
3068 Vesuvius Lane
San Jose, CA 95132
Phone (408) 513-7768
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT33753-TLG | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1164942017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3068 VESUVIUS LN",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951322353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39201 FREMONT BLVD",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381301",
"telephone_number": "510-936-8048"
}
],
"practiceLocations": [
{
"address_1": "3068 Vesuvius Lane",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "95132",
"country_code": "US",
"telephone_number": "408-513-7768",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-21",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT33753-TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.