NPIMap

Organization Active NPI

Vallejo Optometry Group

  • Optometrist
  • Vallejo, CA
National Provider Identifier
1285771592
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10544 Issued in CA
Legal business name
VALLEJO OPTOMETRY GROUP
Practice address
2103 Redwood St
Suite 100
Vallejo, CA 94590-3608
Phone
(707) 554-1773
Fax
(707) 554-1782
NPI assigned
Jan 30, 2007
Organization subpart
Yes
Parent organization
WALNUT CREEK OPTOMETRY GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Dr. Bach-Kim Nguyen, O.D.NPI 1942235734
Title
Owner
Phone
(707) 554-1773

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10544 CA Primary

Addresses

Primary practice location

2103 Redwood St
Suite 100
Vallejo, CA 94590-3608

Mailing address

2103 Redwood St
Suite 100
Vallejo, CA 94590-3608
Phone (707) 554-1773

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ00757ZOtherCAMEDICARE GROUP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Bach-Kim Nguyen2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2103 Redwood St
Ste 100
Vallejo, CA 94590
Phone (707) 554-1773

1844 San Miguel Dr
Ste 312
Walnut Creek, CA 94596
Phone (925) 934-4313

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1285771592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 REDWOOD ST",
            "address_2": "SUITE 100",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945903608",
            "telephone_number": "707-554-1773",
            "fax_number": "707-554-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 REDWOOD ST",
            "address_2": "SUITE 100",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945903608",
            "telephone_number": "707-554-1773",
            "fax_number": "707-554-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEJO OPTOMETRY GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALNUT CREEK OPTOMETRY GROUP",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "BACH-KIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-554-1773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "ZZZ00757Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.