Organization Active NPI

Laura Nguyen OD, Inc

  • Optometrist
  • Riverside, CA
National Provider Identifier
1295952968
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10794T Issued in CA
Legal business name
LAURA NGUYEN OD, INC
Practice address
10191 Magnolia Ave # B
Riverside, CA 92503-3444
Phone
(951) 785-0250
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Dr. Laura NguyenNPI 1952336927
Title
Optometrist
Phone
(951) 785-0250

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 MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 10794T CA Primary

Addresses

Primary practice location

10191 Magnolia Ave # B
Riverside, CA 92503-3444

Mailing address

10191 Magnolia Ave # B
444 Waterman Ave.
Riverside, CA 92503-3444

Other identifiers 1

IdentifierTypeStateIssuer
SD0107940MedicaidCA

Other names 1

  • Clear Vision Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819001556 CA Part B Supplier - Clinic/Group Practice 6507838950 Receives reassigned benefits from 1 practitioner
Practice locations: San Bernardino, CA

National Provider Directory

National Provider Directory

Locations

10191 Magnolia Ave
#B444
Riverside, CA 92503

10191 Magnolia Ave
#B
Riverside, CA 92503
Phone (951) 785-0250

444 S Waterman Ave
San Bernardino, CA 92408
Phone (909) 890-0015

Practitioners 2

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": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1295952968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10191 MAGNOLIA AVE # B",
            "address_2": "444 WATERMAN AVE.",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10191 MAGNOLIA AVE # B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033444",
            "telephone_number": "951-785-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA NGUYEN OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "951-785-0250",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10794T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0107940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Vision Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.