Christyn Mai Phan O D Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

12640T Issued in CA

Legal business name

CHRISTYN MAI PHAN O D INC

Practice address

9862 Chapman Ave Ste a
Garden Grove, CA 92841-2726

Phone

(714) 636-9200

Fax

(714) 636-9424

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Christyn Mai Phan, O.D.

Title

President

Phone

(714) 636-9200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Christyn Mai, O.D.

  • Optometrist
  • Garden Grove, CA
  • NPI 1518043645
  Medicare reassignment NPD
• Thuytien Thi Truong, O.D.

  • Optometrist
  • Los Angeles, CA
  • NPI 1407987274
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1497823306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9862 CHAPMAN AVE STE A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928412726",
            "telephone_number": "714-636-9200",
            "fax_number": "714-636-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9862 CHAPMAN AVE STE A",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928412726",
            "telephone_number": "714-636-9200",
            "fax_number": "714-636-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTYN MAI PHAN O D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "CHRISTYN",
        "authorized_official_middle_name": "MAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-636-9200",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12640T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0126400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samin Chowdhury
• Hearng Choy
• Martin R Christensen
• Christine Huynh Tran,M.D. Inc.
• Christopher R Winkle, M D
• Judy Chu
• Raymond K Chu, RPH
• Thang Tat Chu, PHARMACIST
• Wai C Chu, DDS
• Wai Ming Chu

• Optometrist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.