Individual provider Active NPI

Cindy Quyen Than, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1316103633
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13602 Issued in CA
Practice address
Navy Air Station North Island
Building 2017
San Diego, CA 92135-9213
Phone
(619) 313-2089
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X WA 60146389 WA
Optometrist 152W00000X 13602 CA Primary

Addresses

Primary practice location

Navy Air Station North Island
Building 2017
San Diego, CA 92135-9213

Mailing address

Navy Air Station North Island
Building 2017
San Diego, CA 92135-1202
Phone (619) 313-2089

Other identifiers 1

IdentifierTypeStateIssuer
1316103633MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190531001517 CA Practitioner - Optometry 0648462689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Navy Air Station N Island
Building 2017
San Diego, CA 92135
Phone (619) 313-2089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WA 60146389WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pier Vision Optometry Optometrist CurrentSince Oct 1, 2018 Accepting new patients
Luxottica of America Inc PastSince Oct 20, 2019 Accepting new patients

Locations

2525 El Camino Real
Ste 125
Carlsbad, CA 92008
Phone (714) 867-4801

2561 El Camino Real
Carlsbad, CA 92008
Phone (760) 729-6030

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1316103633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVY AIR STATION NORTH ISLAND",
            "address_2": "BUILDING 2017",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921351202",
            "telephone_number": "619-313-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVY AIR STATION NORTH ISLAND",
            "address_2": "BUILDING 2017",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921359213",
            "telephone_number": "619-313-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAN",
        "first_name": "CINDY",
        "middle_name": "QUYEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "WA 60146389",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316103633",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.