Active NPI
Minh Thi Pham, O.D.
- Optometrist
- City of Industry, CA
National Provider Identifier
1528111259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11386T
- Practice address
- 1600 S Azusa Ave
Unit 527 Puente Hills Mall
City of Industry, CA 91748-1674 - Phone
- (626) 581-7259
- Fax
- (626) 581-7289
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11386T | CA | Primary |
Addresses
Primary practice location
1600 S Azusa Ave
Unit 527 Puente Hills Mall
City of Industry, CA 91748-1674
Mailing address
12247 Yearling PL
Cerritos, CA 90703-7658
Phone (562) 865-7350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11386T | CA | MD | Optometrist |
| 11386 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Eyewear Supplier
- Riverside, CA
- NPI 1366598120
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": "1183852800000",
"number": "1528111259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12247 YEARLING PL",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907037658",
"telephone_number": "562-865-7350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 S AZUSA AVE",
"address_2": "UNIT 527 PUENTE HILLS MALL",
"city": "CITY OF INDUSTRY",
"state": "CA",
"postal_code": "917481674",
"telephone_number": "626-581-7259",
"fax_number": "626-581-7289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "MINH",
"middle_name": "THI",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11386T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in City of Industry, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.