KT Tonnu an Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

10429T Issued in CA

Legal business name

KT TONNU AN OPTOMETRIC CORPORATION

Practice address

1101 E Holt Ave
Ste D
Pomona, CA 91767-5800

Phone

(909) 620-4546

Fax

(909) 620-4546

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Kieutien Phan Tonnu, ODNPI 1639331614

Title

President

Phone

(909) 620-4546

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pomona Optometry Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Kieutien Phan Tonnu, O.D.

  • Optometrist
  • Pomona, CA
  • NPI 1639331614
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1295831485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E HOLT AVE",
            "address_2": "STE D",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675800",
            "telephone_number": "909-620-4546",
            "fax_number": "909-620-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E HOLT AVE",
            "address_2": "STE D",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675800",
            "telephone_number": "909-620-4546",
            "fax_number": "909-620-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KT TONNU AN OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "TONNU",
        "authorized_official_first_name": "KIEUTIEN",
        "authorized_official_middle_name": "PHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-620-4546",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10429T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SDO104290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pomona Optometry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melissa Kreutz
• Hailey Krewson
• Krishan K Malhotra MD Inc
• Peyton John Krych
• Olga Krymskaya
• Abdul Rahman Kublan, MD
• Kristine Faith Kucharik
• Madison Kuhn
• Nathan Derald Kuhnhausen
• Kalyani Kukkadapu

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.