Individual provider Active NPI

Quynh Trang Lin, OD

  • Optometrist
  • South Pasadena, CA
National Provider Identifier
1467064766
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34642 Issued in CA
Practice address
1024 Mission St Ste B
South Pasadena, CA 91030-3198
Phone
(626) 460-6022
NPI assigned
Aug 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34642 CA Primary

Addresses

Primary practice location

1024 Mission St Ste B
South Pasadena, CA 91030-3198

Mailing address

222 S Central Ave Apt 400
Los Angeles, CA 90012-4231

Other practice location 1

6254 Annan Way
Los Angeles, CA 90042-1346
Phone (858) 357-1355

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
I20230824000926 CA Practitioner - Optometry 1759744709 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34642CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mira Mesa Optometry, Inc Optometrist CurrentSince Aug 30, 2024 Accepting new patients
Total Vision PC Optometrist CurrentSince Aug 30, 2024 Accepting new patients
Jaime Chan OD a Professional Corporation Optometrist CurrentSince May 7, 2024 Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist Past Accepting new patients

Locations

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

8230 Mira Mesa Blvd
Ste B
San Diego, CA 92126
Phone (858) 566-6670

Organizations & group practices 4

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1467064766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S CENTRAL AVE APT 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900124231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 MISSION ST STE B",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303198",
            "telephone_number": "626-460-6022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6254 Annan Way",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900421346",
            "country_code": "US",
            "telephone_number": "858-357-1355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "QUYNH TRANG",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

Verify at the official NPI Registry.