NPIMap

Organization Active NPI

Pacific Optometry Vision, Inc.

  • Optometrist
  • West Covina, CA
National Provider Identifier
1598923823
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11932T Issued in CA
Legal business name
PACIFIC OPTOMETRY VISION, INC.
Practice address
2402 S Azusa Ave
West Covina, CA 91792-1512
Phone
(626) 810-4535
Fax
(626) 810-7371
NPI assigned
May 22, 2008
Last updated
Nov 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Dr. Phong Quoc Nguyen, O.D.NPI 1710972195
Title
President
Phone
(626) 810-4535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11932T CA Primary

Addresses

Primary practice location

2402 S Azusa Ave
West Covina, CA 91792-1512

Mailing address

2402 S Azusa Ave
West Covina, CA 91792-1512
Phone (626) 810-4535

Other identifiers 2

IdentifierTypeStateIssuer
6268104535OtherCAVSP
SD0119320MedicaidCA

National Provider Directory

National Provider Directory

Locations

2402 S Azusa Ave
West Covina, CA 91792
Phone (626) 810-4535

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1598923823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 S AZUSA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921512",
            "telephone_number": "626-810-4535",
            "fax_number": "626-810-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 S AZUSA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921512",
            "telephone_number": "626-810-4535",
            "fax_number": "626-810-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC OPTOMETRY VISION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PHONG",
        "authorized_official_middle_name": "QUOC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-810-4535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11932T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "6268104535",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0119320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.