Crest Optometry, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

13778 Issued in CA

Legal business name

CREST OPTOMETRY, INC

Practice address

173 N Morrison Ave
Ste. E
San Jose, CA 95126-2712

Phone

(408) 372-7647

Fax

(408) 598-3332

NPI assigned

Jun 30, 2011

Last updated

Dec 31, 2018By 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

Dr. Phuong B Pham, O.D.NPI 1215262498

Title

President

Phone

(408) 807-4344

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

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.

• Phuong Pham, O.D.

  • Optometrist
  • San Jose, CA
  • NPI 1215262498
  Medicare reassignment Care Compare group NPD Authorized official
• Tina Ting-Li Chang, O.D., M.S.

  • Optometrist
  • Fremont, CA
  • NPI 1427212497
  Medicare reassignment Care Compare group NPD
• Shirley Quicho, O.D.

  • Optometrist
  • San Jose, CA
  • NPI 1023370137
  Medicare reassignment Care Compare group NPD
• Joanne C. Gwo, O.D.

  • Optometrist
  • South San Francisco, CA
  • NPI 1083900336
  Medicare reassignment NPD
• Diem Q Tran, O.D.

  • Optometrist
  • Scotts Valley, CA
  • NPI 1740253590
  Medicare reassignment NPD

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546214400000",
    "number": "1366739195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 N MORRISON AVE STE B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262712",
            "telephone_number": "408-372-7647",
            "fax_number": "408-598-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 N MORRISON AVE",
            "address_2": "STE. E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262712",
            "telephone_number": "408-372-7647",
            "fax_number": "408-598-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2018-12-31",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-807-4344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Crawford, PHD
• Jennifer Ann Crayford
• Craig Norman Creasman, M.D.
• Michael Scott Creekpaum, PHD
• Danielle Angelique Creer
• Crestline Medical Group PC
• Crestpoint Medical LLC
• Crestwood Behavioral Health, Inc (Crestwood Behavioral Health Center)
• Crestwood Behavioral Health, Inc. (Crestwood Psychiatric Health Facility-San Jose)
• Crestwood Behavioral Health, Inc. (Crestwood Center)

• Optometrist in San Jose, CA
• Providers in San Jose, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.