Individual provider Active NPI

Toan A Nguyen, O.D.

  • Optometrist
  • San Marino, CA
National Provider Identifier
1609122308
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33446 Issued in CA
Practice address
2154 Huntington Dr
San Marino, CA 91108-2024
Phone
(316) 990-1585
NPI assigned
Jul 31, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33446 CA Primary
Optometrist 152W00000X 1923 KS

Addresses

Primary practice location

2154 Huntington Dr
San Marino, CA 91108-2024

Mailing address

13250 Don Julian Rd
La Puente, CA 91746-2239
Phone (316) 990-1585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170206001448 CA Practitioner - Optometry 6901054857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Julie Phan OD IncGroup PAC ID 3072833011, 3 clinicians

Practice addresses (Care Compare)

1055 Harriman PL
San Bernardino, CA 92408-4203
Phone (909) 799-3130

2154 Huntington Dr
San Marino, CA 91108-2024
Phone (316) 990-1585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1923KSMDClinical Social Worker
33446CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Toan a Nguyen OD Inc Optometrist CurrentSince Dec 14, 2016 Accepting new patients
Garden City Optometrists, P.a. Optometrist CurrentSince Jan 2, 2007 Accepting new patients
Dr Julie Phan OD Inc Optometrist CurrentSince Oct 30, 2022 Accepting new patients

Locations

2154 Huntington Dr
San Marino, CA 91108
Phone (316) 990-1585

1055 Harriman Pl
Sn Bernrdno, CA 92408
Phone (909) 796-1538

707 E Kansas Plz
Garden City, KS 67846
Phone (620) 275-7507

2602 N Cherokee Rd
Garden City, KS 67846
Phone (620) 276-3381

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1609122308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13250 DON JULIAN RD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917462239",
            "telephone_number": "316-990-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 HUNTINGTON DR",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082024",
            "telephone_number": "316-990-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TOAN",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33446",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1923",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marino, CA

Sources for this page

Verify at the official NPI Registry.