Pham-Vang Optometry LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

3056 Issued in MN

Legal business name

PHAM-VANG OPTOMETRY LLC

Doing business as

Eye Doc

Practice address

7074 Brooklyn Blvd
Brooklyn Center, MN 55429-1370

Phone

(763) 639-0103

NPI assigned

May 27, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Sandy Pham-Vang, ODNPI 1689607780

Title

Ceo

Phone

(763) 316-4193

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Eye Doc Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandy Pham-Vang, OD

  • Corneal and Contact Management Optometrist
  • Brooklyn Center, MN
  • NPI 1689607780
  NPD Authorized official

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1467800664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7074 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291370",
            "telephone_number": "763-639-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7074 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291370",
            "telephone_number": "763-639-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAM-VANG OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "PHAM-VANG",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-316-4193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MN",
            "license": "3056",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "3056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "635140001",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Doc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Lyn Peterson
• Madilyn Mae Peterson
• Tyler Peterson
• Andrea Sheree Petitt
• Peter George Pfeiffer
• Pham-Vang Optometry LLC
• Sandy Pham-Vang, OD
• Jack Edward Philbin
• Danayah M Phillips
• Mar'Shell Phillips

• Health Maintenance Organization in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Health Maintenance Organization in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.