Active NPI
Laura Nguyen OD, Inc
- Optometrist
- Riverside, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10794T
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Laura Nguyen
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0107940 | Medicaid | CA |
Other names 1
- Clear Vision Optometry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Optometrist
- Mira Loma, CA
- NPI 1922148634
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.