Individual provider Active NPI

Thu Thi Nguyen, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1326323627
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14274 Issued in CA
Practice address
4840 Shawline St
San Diego, CA 92111-1400
Phone
(858) 560-5742
NPI assigned
Oct 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14274 CA Primary

Addresses

Primary practice location

4840 Shawline St
San Diego, CA 92111-1400

Mailing address

6126 Daisy PL
San Diego, CA 92114-6612

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20130424000550 CA Practitioner - Optometry 8820234669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

1809 National Ave
San Diego, CA 92113-2113
Phone (619) 515-2300

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

525 E Main St
El Cajon, CA 92020-4007
Phone (619) 515-2498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14274CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Feb 3, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 26, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 26, 2023 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Feb 3, 2025 Accepting new patients
Castillejos Eye Institute Medical Group Optometrist Past Accepting new patients
Castillejos Eye Institute Medical Group Past Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 7

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": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1326323627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6126 DAISY PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921146612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 SHAWLINE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111400",
            "telephone_number": "858-560-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THU",
        "middle_name": "THI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.