Individual provider Active NPI

Taylor Vuong Lam, O.D.

  • Optometrist
  • El Monte, CA
National Provider Identifier
1376617787
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11907T Issued in CA
Practice address
10012 Garvey Ave Ste 12
El Monte, CA 91733-2087
Phone
(626) 401-0324
Fax
(626) 401-9224
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11907T CA Primary

Addresses

Primary practice location

10012 Garvey Ave Ste 12
El Monte, CA 91733-2087

Mailing address

10012 Garvey Ave Ste 12
El Monte, CA 91733-2087
Phone (626) 401-0324

Other identifiers 3

IdentifierTypeStateIssuer
SDO119070MedicaidCA
SD0119070OtherCABLUE SHIELD OF CALIFORNIA
3391835OtherCAAETNA

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
I20090317000671 CA Practitioner - Optometry 7719044866 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11907TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Annie H Nguyen OD Inc Optometrist CurrentSince Jul 13, 2025 Accepting new patients

Locations

10012 Garvey Ave
Ste 12
El Monte, CA 91733
Phone (626) 401-0324

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1376617787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 GARVEY AVE STE 12",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917332087",
            "telephone_number": "626-401-0324",
            "fax_number": "626-401-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 GARVEY AVE STE 12",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917332087",
            "telephone_number": "626-401-0324",
            "fax_number": "626-401-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "TAYLOR",
        "middle_name": "VUONG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11907T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SDO119070",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "SD0119070",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3391835",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.