Crystal Vision Optometry, a Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

10146T Issued in CA

Legal business name

CRYSTAL VISION OPTOMETRY, A PROFESSIONAL CORPORATION

Practice address

16125 Harbor Blvd
Fountain Valley, CA 92708-1305

Phone

(714) 531-9900

Fax

(714) 531-0236

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Anh-Linh Teresa Nguyen, O.D.NPI 1124016183

Title

President

Phone

(714) 531-9900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CRYSTAL VISION OPTOMETRY Doing business as

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.

• Anh-Linh Teresa Nguyen, OD

  • Optometrist
  • Santa Ana, CA
  • NPI 1124016183

  CA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1174573380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 S HARBOR BLVD STE C",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047901",
            "telephone_number": "714-531-9900",
            "fax_number": "714-531-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16125 HARBOR BLVD",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081305",
            "telephone_number": "714-531-9900",
            "fax_number": "714-531-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL VISION OPTOMETRY, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "ANH-LINH",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-531-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10146T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0101460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRYSTAL VISION OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CRYSTAL VISION OPTOMETRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charee Nicole Crisci
• Bryar Crisfield, SLP
• Mark Andrew Cromer, C.P.O.
• Maria Alexa Crosby, PT
• Adamaris Cruz
• Stefan Cukic
• Dina Mari Cuppinger
• Cura Finanical, Inc.
• Sharmeline Curameng, MSN, FNP
• Jennifer Sarah Curran, M.S, CCC-SLP

• All providers in Fountain Valley, CA
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.