Pomona Valley Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

152W00000X Issued in CA

Legal business name

POMONA VALLEY OPTOMETRY INC

Practice address

1900 Royalty Dr
Ste 100
Pomona, CA 91767-3048

Phone

(909) 469-4804

Fax

(909) 469-4807

NPI assigned

Feb 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Khanh Van Le, ODNPI 1760526842

Title

President

Phone

(909) 469-4804

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Khanh V. Le, O.D.

  • Optometrist
  • Pomona, CA
  • NPI 1760526842
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Grace Le, OD

  • Optometrist
  • Pomona, CA
  • NPI 1932938883
  Medicare reassignment Care Compare group NPD
• Eric Verret, OD

  • Optometrist
  • Escondido, CA
  • NPI 1194891853
  NPD (past)

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1316911100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 ROYALTY DR",
            "address_2": "STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673048",
            "telephone_number": "909-469-4804",
            "fax_number": "909-469-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ROYALTY DR",
            "address_2": "STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673048",
            "telephone_number": "909-469-4804",
            "fax_number": "909-469-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMONA VALLEY OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-16",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "KHANH",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-469-4804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "152W00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0095951",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pomona Valley Hospital Medical Center
• Pomona Valley Hospital Medical Center
• Pomona Valley Imaging Group
• Pomona Valley Imaging Medical Group Inc
• Pomona Valley Neonatology Medical Group
• Pomona Valley Podiatry Group Inc
• Pomona Valley Rehabilitation Center LLC
• Pomona Valley Specialty Surgery Center, LLC
• Jesse Glenn Pompa
• Doreen Pon, PHARMD

• 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 20, 2023; 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.