Mimi Anh Saysomphane, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34135TLG Issued in CA

Practice address

17801 Pioneer Blvd Ste F
Artesia, CA 90701-3962

Phone

(714) 642-5260

NPI assigned

Oct 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Michael S. Chang O.D. Inc.

  • Optometrist
  • Artesia, CA
  • NPI 1952573982
  Medicare reassignment NPD

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1295201390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13361 PARTRIDGE ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928433016",
            "telephone_number": "714-642-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17801 PIONEER BLVD STE F",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013962",
            "telephone_number": "714-642-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYSOMPHANE",
        "first_name": "MIMI",
        "middle_name": "ANH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34135TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vianey Sanchez
• Darwin Santos, PT
• Roma Kristel Santos, PT
• Donnatila Dayao Sapiandante, D.C.
• Sarah a Cupino DMD Inc
• SDKJ Forever, LLC.
• Selene Home Health Group Inc
• Mehdi Shah
• Priti Shah
• Camila Shelton

• Optometrist in Artesia, CA
• Providers in Artesia, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.