Jimmy Quang OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JIMMY QUANG OD INC

Doing business as

Mission Optometric Center

Practice address

31401 Rancho Viejo Rd Ste 103
San Juan Capistrano, CA 92675-1850

Phone

(949) 443-3794

Fax

(949) 443-3828

NPI assigned

Dec 12, 2019

Last updated

Sep 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jimmy Quang, ODNPI 1932655164

Title

President

Phone

(510) 637-9987

Specialties & licenses 1

Addresses

Other names 1

• Mission Optometric Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jimmy Quang, OD

  • Optometrist
  • San Juan Capistrano, CA
  • NPI 1932655164
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725667200000",
    "number": "1336787043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31401 RANCHO VIEJO RD STE 103",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751850",
            "telephone_number": "510-637-9987",
            "fax_number": "949-443-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31401 RANCHO VIEJO RD STE 103",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751850",
            "telephone_number": "949-443-3794",
            "fax_number": "949-443-3828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27725 Santa Margarita Pkwy Ste 131",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926916706",
            "country_code": "US",
            "telephone_number": "949-770-8505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JIMMY QUANG OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A",
        "authorized_official_last_name": "QUANG",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-637-9987",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Optometric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2024; 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.