Individual provider Active NPI

Hesper Pham, O.D.

  • Optometrist
  • Mission Viejo, CA
National Provider Identifier
1265728570
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15212 Issued in CA
Practice address
27871 Medical Center Rd Ste 120
Mission Viejo, CA 92691-6405
Phone
(949) 364-6688
Fax
(949) 368-6689
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15212 CA Primary

Addresses

Primary practice location

27871 Medical Center Rd Ste 120
Mission Viejo, CA 92691-6405

Mailing address

9061 Bolsa Ave Ste 105
Westminster, CA 92683-5558
Phone (714) 899-5670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150730014015 CA Practitioner - Optometry 5799099024 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas S Tooma M D a Professional Corporation Optometrist CurrentSince Dec 1, 2022 Accepting new patients
Luis a Chanes M D Inc CurrentSince Dec 1, 2021 Accepting new patients
Cuong-Dung DO, M.D., Inc CurrentSince Jul 4, 2015 Accepting new patients
Thomas S Tooma M D a Professional Corporation Optometrist CurrentSince Dec 1, 2022 Accepting new patients
St Joseph Hospital of Orange PastSince Jul 4, 2015 Accepting new patients

Locations

27871 Medical Center Rd
Ste 120
Mission Viejo, CA 92691
Phone (714) 901-2006

4220 Von Karman Ave
Ste 100
Newport Beach, CA 92660
Phone (949) 284-7428

3655 Nobel Dr
Ste 130
San Diego, CA 92122
Phone (858) 283-5371

2621 S Bristol St
Ste 205
Santa Ana, CA 92704
Phone (714) 557-5777

9061 Bolsa Ave
Ste 105
Westminster, CA 92683
Phone (714) 899-5670

Organizations & group practices 5

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1265728570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9061 BOLSA AVE STE 105",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835558",
            "telephone_number": "714-899-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27871 MEDICAL CENTER RD STE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916405",
            "telephone_number": "949-364-6688",
            "fax_number": "949-368-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HESPER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.