Phung My Quach, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12643T Issued in CA

Practice address

9600 Bolsa Ave
Ste C & H
Westminster, CA 92683-5949

Phone

(714) 775-7045

Fax

(714) 775-7050

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Phung Quach, OD Inc.

  • Optometrist
  • Lakewood, CA
  • NPI 1043604051
  Medicare reassignment NPD Authorized official
• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1407912074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9002 MADISON AVE",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835516",
            "telephone_number": "714-894-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BOLSA AVE",
            "address_2": "STE C & H",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835949",
            "telephone_number": "714-775-7045",
            "fax_number": "714-775-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACH",
        "first_name": "PHUNG",
        "middle_name": "MY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12643T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pulmonary Disease Services
• Natalie Pung
• Pure Path Recovery
• Nathan Puskas
• Q Pharmacy Inc
• Quang CHI Quach, D.O.
• Thomas T Quach, MD
• Vy-Hang Dang Quach
• Quality Healthcare Services Inc.
• Hanh Quan, DDS

• Optometrist in Westminster, CA
• Providers in Westminster, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.