Individual provider Active NPI

Lien Thi Kim Nguyen, O.D.

  • Optometrist
  • Colton, CA
National Provider Identifier
1396896791
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13106 Issued in CA
Practice address
1120 S Mount Vernon Ave
Colton Walmart
Colton, CA 92324-4220
Phone
(909) 783-4850
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13106 CA Primary

Addresses

Primary practice location

1120 S Mount Vernon Ave
Colton Walmart
Colton, CA 92324-4220

Mailing address

1120 S Mount Vernon Ave
Colton Walmart
Colton, CA 92324-4220
Phone (909) 783-4850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13106CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nguyen-Ho Optometry, PC Optometrist CurrentSince Sep 5, 2023 Accepting new patients
Luxottica of America Inc. Past Accepting new patients

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1396896791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S MOUNT VERNON AVE",
            "address_2": "COLTON WALMART",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244220",
            "telephone_number": "909-783-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S MOUNT VERNON AVE",
            "address_2": "COLTON WALMART",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244220",
            "telephone_number": "909-783-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LIEN",
        "middle_name": "THI KIM",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.