Individual provider Active NPI

Cory Nguyen Vu, O.D.

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1245366897
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10438T Issued in CA
Practice address
1501 Capitol Ave Ste 71.5144
Ms 4600
Sacramento, CA 95814-5005
Phone
(916) 552-9539
Fax
(916) 440-5640
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10438T CA Primary

Addresses

Primary practice location

1501 Capitol Ave Ste 71.5144
Ms 4600
Sacramento, CA 95814-5005

Mailing address

1501 Capitol Ave Ste 71.5144
P.O. Box 997413, Ms 4600
Sacramento, CA 95814-5005
Phone (916) 552-9539

Other identifiers 1

IdentifierTypeStateIssuer
SD0104380MedicaidCA

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
10438TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245366897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 CAPITOL AVE STE 71.5144",
            "address_2": "P.O. BOX 997413, MS 4600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145005",
            "telephone_number": "916-552-9539",
            "fax_number": "916-440-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 CAPITOL AVE STE 71.5144",
            "address_2": "MS 4600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145005",
            "telephone_number": "916-552-9539",
            "fax_number": "916-440-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "CORY",
        "middle_name": "NGUYEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10438T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0104380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.