Primigenia Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 9757 TPA Issued in CA

Legal business name

PRIMIGENIA OPTOMETRY INC

Doing business as

Vision Max Optometry

Practice address

14461 Merced Ave
Suite 101
Baldwin Park, CA 91706-5100

Phone

(626) 939-4588

Fax

(626) 939-4590

NPI assigned

Apr 10, 2007

Last updated

Dec 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mia Mengya Hung, O.D.NPI 1720191505

Title

President

Phone

(626) 939-4588

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vision Max Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mia M Hung, O.D.

  • Optometrist
  • Chino, CA
  • NPI 1720191505
  Medicare reassignment NPD Authorized official
• Cara Anderson, OD

  • Optometrist
  • Chino, CA
  • NPI 1992681373
  Medicare reassignment NPD
• Kerry Scot Anderson, O.D.

  • Optometrist
  • Chino, CA
  • NPI 1851404628
  Medicare reassignment NPD
• Alan H. Leventhal, OD

  • Optometrist
  • Baldwin Park, CA
  • NPI 1669409710
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1578786398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14461 MERCED AVE",
            "address_2": "SUITE 101",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065100",
            "telephone_number": "626-939-4588",
            "fax_number": "626-939-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14461 MERCED AVE",
            "address_2": "SUITE 101",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065100",
            "telephone_number": "626-939-4588",
            "fax_number": "626-939-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMIGENIA OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "HUNG",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "MENGYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-939-4588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 9757 TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578786398",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Max Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy H. Porter, MD
• Poulter Enterprises Inc (Medicine Shoppe)
• Edgar Daniel Prado
• Prakash P. Patel D.DS Inc
• Gabrielle Ilsa Preston, RN
• Brett Allen Provence, D.O.
• Puente Partners,LLC (Victoria Care Center)
• Judith Pye, LCSW
• Jessica M Pyun, DMD
• Chunyuan Qiu, MD

• Optometrist in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.