Individual provider Active NPI

Vivian Van Phung, OD

  • Optometrist
  • Long Beach, CA
National Provider Identifier
1235976184
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35808 Issued in CA
Practice address
5901 E 7TH St
Long Beach, CA 90822-5201
Phone
(714) 273-4885
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35808 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5901 E 7TH St
Long Beach, CA 90822-5201

Mailing address

2105 W Cherry Dr
Orange, CA 92868-1928
Phone (714) 273-4885

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

LicenseStateTypeSpecialty
35808CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1235976184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 W CHERRY DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681928",
            "telephone_number": "714-273-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 E 7TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908225201",
            "telephone_number": "714-273-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "VIVIAN",
        "middle_name": "VAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35808",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.