V. Phan Optometric Prof Corp

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

13193 T Issued in CA

Legal business name

V. PHAN OPTOMETRIC PROF CORP

Doing business as

Placentia Family Optometry

Practice address

1525 N Placentia Ave
Unit a
Placentia, CA 92870-2334

Phone

(714) 792-3619

Fax

(714) 792-3603

NPI assigned

Jun 9, 2014

Organization subpart

No

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

Authorized official

Name

Van Phan, O.D

Title

Optometrist

Phone

(714) 234-3080

Specialties & licenses 1

Addresses

Other names 1

• Placentia Family Optometry Doing business as

Locations

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1568875482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 W MERCED TRAIL ROAD",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92865",
            "telephone_number": "714-234-3080",
            "fax_number": "714-792-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 N PLACENTIA AVE",
            "address_2": "UNIT A",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928702334",
            "telephone_number": "714-792-3619",
            "fax_number": "714-792-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V. PHAN OPTOMETRIC PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "VAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "714-234-3080",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "13193 T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Placentia Family Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Preferred Provider Organization in Placentia, CA
• Providers in Placentia, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.