Active NPI
James Van Phung, OD.
- Optometrist
- San Marcos, CA
National Provider Identifier
1225181951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12721T
- Practice address
- 732 Center Dr.
San Marcos, CA 92069 - Phone
- (760) 839-5161
- Fax
- (760) 741-7160
- NPI assigned
- Jan 18, 2007
- Last updated
- Dec 4, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12721 | CA | |
| Optometrist | 152W00000X | 12721T | CA | Primary |
Addresses
Primary practice location
732 Center Dr.
San Marcos, CA 92069
Mailing address
10050 Scripps Vista Way Unit 28
San Diego, CA 92131
Phone (858) 401-9088
Other practice location 1
3030 Plaza Bonita Rd
National City, CA 91950-8009
Phone (619) 267-8500
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12721 | CA | MD | Optometrist |
| 12721T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- San Marcos, CA
- NPI 1336068329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1225181951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10050 SCRIPPS VISTA WAY UNIT 28",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92131",
"telephone_number": "858-401-9088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 CENTER DR.",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "92069",
"telephone_number": "760-839-5161",
"fax_number": "760-741-7160"
}
],
"practiceLocations": [
{
"address_1": "3030 Plaza Bonita Rd",
"address_purpose": "LOCATION",
"city": "National City",
"state": "CA",
"postal_code": "919508009",
"country_code": "US",
"telephone_number": "619-267-8500",
"fax_number": "619-267-4983",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHUNG",
"first_name": "JAMES",
"middle_name": "VAN",
"credential": "OD.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12721",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12721T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Marcos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.