Individual provider Active NPI

My D Guino-O, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1255496196
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12564T Issued in CA
Practice address
2009 Tully Rd
San Jose, CA 95122-1801
Phone
(408) 729-1000
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12564T CA Primary

Addresses

Primary practice location

2009 Tully Rd
San Jose, CA 95122-1801

Mailing address

2009 Tully Rd
San Jose, CA 95122-1801
Phone (408) 729-1000

Other names 1

  • My B Diep Professional name

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

LicenseStateTypeSpecialty
12564TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyesite2020, LLC Optometrist CurrentSince Apr 16, 2023 Accepting new patients
Luxottica of America Inc. Past Accepting new patients

Locations

2009 Tully Rd
San Jose, CA 95122
Phone (408) 729-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1255496196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 TULLY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221801",
            "telephone_number": "408-729-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 TULLY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221801",
            "telephone_number": "408-729-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUINO-O",
        "first_name": "MY",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12564T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MY",
            "last_name": "DIEP",
            "middle_name": "B",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.