Individual provider Active NPI

Andrian L Nguyen, O.D.

  • Optometrist
  • Westminster, CA
National Provider Identifier
1497808208
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13115 Issued in CA
Practice address
9200 Bolsa Ave
#119A
Westminster, CA 92683-5500
Phone
(714) 786-8468
Fax
(714) 786-8467
NPI assigned
Jan 18, 2007
Last updated
Dec 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13115 CA Primary

Addresses

Primary practice location

9200 Bolsa Ave
#119A
Westminster, CA 92683-5500

Mailing address

9200 Bolsa Ave
#119A
Westminster, CA 92683-5500
Phone (714) 786-8468

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
I20070423000521 CA Practitioner - Optometry 7012012842 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13115CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Smart Optometry Inc Optometrist CurrentSince Jan 1, 2013 Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

9200 Bolsa Ave
Ste 119A
Westminster, CA 92683
Phone (714) 248-6673

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1497808208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 BOLSA AVE",
            "address_2": "#119A",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835500",
            "telephone_number": "714-786-8468",
            "fax_number": "714-786-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 BOLSA AVE",
            "address_2": "#119A",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835500",
            "telephone_number": "714-786-8468",
            "fax_number": "714-786-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANDRIAN",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.