Organization Active NPI

Diana Nguyen Optometry Inc

  • Optometrist
  • Santa Ana, CA
National Provider Identifier
1225266463
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 12457 TPL Issued in CA
Legal business name
DIANA NGUYEN OPTOMETRY INC
Practice address
903 S Bristol St Ste a
Santa Ana, CA 92703-4983
Phone
(714) 564-9696
Fax
(714) 784-7891
NPI assigned
Jun 25, 2009
Last updated
Mar 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Diana Nguyen, O. DNPI 1649499229
Title
President
Phone
(714) 200-4261

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 12457 TPL CA Primary

Addresses

Primary practice location

903 S Bristol St Ste a
Santa Ana, CA 92703-4983

Mailing address

903 S Bristol St Ste a
Santa Ana, CA 92703-4983
Phone (714) 564-9696

Other identifiers 1

IdentifierTypeStateIssuer
FP987AOtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111214000552 CA Part B Supplier - Clinic/Group Practice 2567637887 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Ana, CA

National Provider Directory

National Provider Directory

Locations

903 S Bristol St
Ste A
Santa Ana, CA 92703
Phone (714) 564-9696

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1225266463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 S BRISTOL ST STE A",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927034983",
            "telephone_number": "714-564-9696",
            "fax_number": "714-784-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 S BRISTOL ST STE A",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927034983",
            "telephone_number": "714-564-9696",
            "fax_number": "714-784-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA NGUYEN OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-200-4261",
        "authorized_official_credential": "O. D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 12457 TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "FP987A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.